Clinic Nurse Medical Case Manager - Workers Compensation

Company: The Travelers Indemnity Company
Location: Hartford
Posted on: May 5, 2025

Job Description:

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 160 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.Compensation OverviewThe 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 will be determined by factors including role scope, complexity, location, candidate skills, education, experience, and other employment conditions. Employees are also eligible for performance-based cash incentives as part of our compensation and benefits program.Salary Range$83,300.00 - $137,400.00Target Openings1What Is the Opportunity?Under moderate supervision, provide office-based telephonic and/or in-person medical case management supporting Concierge locations, focusing on early intervention, return-to-work planning, coordination of medical care on disability and treatment claims, and in-house medical reviews as applicable to claim laws and regulations. Help ensure injured parties receive appropriate treatment related to the injury or assist claim handlers in managing medical treatment to resolution.What Will You Do?

• Meet with injured employees face-to-face following office visits to assist with the claim process and ensure treatment plan compliance.
• Coordinate with customers, medical providers, and injured parties on claims involving treatment and disability to facilitate appropriate care and return to work.
• Develop strategies for injured employees' return to work and medical improvement, updating plans as needed.
• Coordinate with medical providers to ensure active participation in treatment plans.
• Evaluate medical treatment requests for reasonableness and necessity per jurisdictional guidelines.
• Engage specialty resources as needed to optimize resolution.
• Partner with Claim Professionals to provide medical information and disability status for claim strategy.
• Manage claim activities using internal Claim Platform Systems.
• Utilize Preferred Provider Network per jurisdictional guidelines.
• Provide input on medical treatment and recovery time to support reserve evaluation.
• Submit accurate billing documentation per guidelines.
• Engage with customers and participate in file reviews.
• Respond to inquiries and keep injured workers informed about claim status.
• Obtain and maintain necessary insurance licenses and/or certifications within three months, if required.
• Perform other duties as assigned.What Will Our Ideal Candidate Have?
  • RN preferred.
  • Disability case management experience preferred.
  • Clinical experience preferred.
  • Familiarity with URAC standards.
  • Strong analytical, communication, negotiation, and insurance contract knowledge skills.
  • Intermediate investigative skills and basic legal knowledge relevant to insurance.
  • Thorough medical knowledge of injuries, disability, and treatment.
  • Understanding of WC products and jurisdictional parameters.
  • Excellent customer service, teamwork, planning, and organizing skills.
  • Certification such as CCM, CDMS, CRC, or CRRN preferred.What is a Must Have?
    • Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse required.What Is in It for You?
      • Comprehensive health insurance coverage from day one.
      • Retirement benefits including 401(k) matching, student loan repayment programs, and pension plan.
      • Minimum of 20 days Paid Time Off plus holidays.
      • Wellness and mental health programs.
      • Volunteer and community engagement opportunities with matching gifts and rewards.Employment PracticesTravelers is an equal opportunity employer that values diversity and inclusion. Candidates in Colorado are not required to disclose educational attendance dates. For questions about physical requirements, contact us via email. We reserve the right to adjust the level of the position. For more information on benefits, visit .
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Keywords: The Travelers Indemnity Company, Lowell , Clinic Nurse Medical Case Manager - Workers Compensation, Human Resources , Hartford, Massachusetts