RN Outpatient Full-time
Travelers

Clinic Nurse Medical Case Manager - Workers Compensation

$85,600 - $141,200 / year

Who Are We?

Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.

Job Category

Claim, Nurse - Medical Case Manager

Compensation Overview

The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

Salary Range

$85,600.00 - $141,200.00

Target Openings

1

What Is the Opportunity?

This is a unique opportunity to have face to face time while working as a case manager.

This position will work out of the Aspinwall Concentra Clinic in Pittsburgh. Concentra address: 15 Freeport Rd, Pittsburgh, PA 15215

Under moderate supervision, provide office based telephonic and/or in-person medical case management supporting Concierge locations with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment as well as in-house medical reviews as applicable to claim handling laws and regulations. Responsible for helping to ensure injured parties receive appropriate treatment directly related to the compensable injury or assist claim handlers in managing medical treatment to an appropriate resolution.

What Will You Do?

  • Meet with injured employees face to face following office visits at a provider's medical facility to assist with the claim process and ensure compliance with their medical treatment plan.
  • Contact customer, medical provider and injured parties on claims involving medical treatment and /or disability to coordinate appropriate medical care and return to work.
  • Develop strategies to facilitate an injured employee's return to work and achieve maximum medical improvement. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim.
  • Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan.
  • Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines.
  • Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor, peer reviews, MCU).
  • Partner with Claim Professional to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome.
  • Utilize internal Claim Platform Systems to manage all claim activities on a timely basis.
  • Utilize Preferred Provider Network per jurisdictional guidelines.
  • Partner with Claim Professional to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves.
  • Submit accurate billing documentation on all activities as outlined in established guidelines.
  • Customer Engagement.
  • Participate in Telephonic and/or onsite File Reviews.
  • Respond to inquiries - oral and written.
  • Keep injured worker apprised of claim status.
  • In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) and/or certifications may be required to comply with state and Travelers requirements. Generally, License(s) are required to be obtained within three months.
  • Perform other duties as assigned.

What Will Our Ideal Candidate Have?

  • RN preferred.
  • Disability case management experience.
  • Prior clinical experience.
  • Familiarity with URAC standards.
  • Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making.
  • Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology.
  • Ability to effectively present file resolution to internal and/or external stakeholders.
  • Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise.
  • General Insurance Contract Knowledge: Ability to understand policies and contracts, as they apply to policy conditions.
  • Principles of Investigation: Intermediate investigative skills.
  • Follows a logical sequence of inquiry with a goal of securing information about the work accident, resulting injury, anticipated treatment, job duties and any material factors that may impact recovery and return to work.
  • Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves.
  • Legal Knowledge: Basic knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
  • Medical knowledge: Thorough knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
  • WC Technical: intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to manage treatment plans and assist with claim resolution.
  • Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state.
  • Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes.
  • Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result.
  • Planning & Organizing: Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals.
  • Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Clinical Research Counselor (CRC), or Certified Rehab Registered Nurse (CRRN).

What is a Must Have?

  • Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse.

What Is in It for You?

  • Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
  • Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
  • Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
  • Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
  • Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

Employment Practices

Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. 

In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.

If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.

Travelers reserves the right to fill this position at a level above or below the level included in this posting.

To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.

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Registered Nurse (RN)

$49 - $63 / hour
Get paid up to $63 an hour as a Registered Nurse (RN) in Apollo, PA (and nearby areas), with the freedom to set your own schedule and the benefits of W2 employment. By creating your own schedule, you can work as much as you like, and take off all the time you want. Simply use our mobile-friendly app to pick and choose shifts at any of our partner facilities, and experience the work-life balance you deserve. As a member of our team, you get to decide when, where, and how much you work. This allows you to free up time for your personal life, without stressing about work conflicts. Sign up for work shifts around your favorite routines and hobbies, like morning jogs in Roaring Run Trail. Make plans for that family picnic at Northmoreland Park, knowing that you don't have to accommodate a work schedule that's out of your hands. When you control your own time, you get to set your own pace. Find out more about our benefits, below, and consider becoming part of our encouraging team today. Benefits RN hourly rate between $49 and $63 Get paid rates that are up to 25% higher on average, with weekly and daily pay options Opportunities for overtime as well as boosted rates for holidays Quickly find shifts in all states where you're authorized to practice Set your own schedule by selecting only your preferred shifts at any of our partner facilities Choose from weekday/weekend shifts, day/evening/overnight shifts, and more 401k retirement plan Upskilling opportunities with a dedicated team of quality assurance nursing professionals Eligibility for medical, dental, and vision insurance for you and qualifying family members Employer tax withholding each pay period Employer coverage for workers' comp and malpractice insurance Undergraduate and graduate tuition discounts at Excelsior University (up to 34%) Manage your shifts and access workplace perks like free continuing education courses through an all-in-one app Want to know what it's like to work for IntelyCare — straight from the source? Here are some reviews from a few of our "IntelyPros" to give you a sense of what it's like to be a part of our team: "IntelyCare is 10/10! I have worked with them for a little over two years and I have never been disappointed. The customer service staff takes care of everything you need in a very timely manner." "IntelyCare works with us, not against us! I have been feeling the support from the moment I started. Everyone here is willing to help you achieve your goals, and for that to happen you don’t necessarily have to be a full-time employee." "Since I joined IntelyCare, I have been stress-free! I make my own schedule, I get to spend more time with my family, and make enough to cover my expenses." "I love IntelyCare because it is extremely convenient and reliable. This job alone has saved me from being in debt and is keeping a roof over my head…There are so many benefits from being an IntelyPro: a good retirement plan, health insurance, shift variety, and a team that actually cares about you. I love being an IntelyPro!" Job Responsibilities Delivering high quality, resident-centered care while working as a RN in post-acute facilities Coordinating with the broader care team to shape personalized care plans for residents Communicating various care options with medical staff, residents, and their family members Taking and monitoring vital signs and drawing fluids as needed for lab work Delivering medications and administering treatments to residents Documenting vital signs, nursing interventions and responses, medical histories, and other relevant information in resident records Ensuring the effective use of medical equipment and devices Assisting staff members with incident investigations Complying with all applicable laws, regulations, policies, and standards of care Training nursing professionals and support staff as needed consistent with scope of practice requirements Being accountable to follow and adhere to resident care plans Qualifications and Skills Current Pennsylvania state license to practice as a Registered Nurse (RN) 6 months of experience (in an RN or related role) Completion of an approved nursing program High level of organizational skills Demonstrated ability to effectively communicate across medical and nursing teams Ability to lift at least 50 lbs Ready for a Job That Puts Your Needs First? As you search for Registered Nurse (RN) jobs in your area, you don't have to settle for the work-life imbalance that you may be used to. If you're ready for something better, we're ready for you. Take the next step today by applying to the team ranked #1 in quality. COVID-19 Considerations: COVID-19 vaccination requirements vary by state. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Location: Apollo, Pennsylvania 15613