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Nurse Medical Case Manager - Workers Compensation - Gardena

Gardena, California

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 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

$76,300.00 - $125,900.00

Target Openings

1

What Is the Opportunity?

This position will work out of a Concentra clinic in Gardena, CA. The clinic is located at 16630 S. Broadway St. Gardena CA 90248. This is a unique opportunity to have face to face time while working as a case manager.

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. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.

Due to applicable regulatory requirements, employees in this position must be fully vaccinated against COVID-19 or receive an approved accommodation based on medical condition or sincerely held religious belief or practice, or as otherwise required by applicable law. Employees who receive an approved accommodation will be required to undergo COVID-19 testing in accordance with applicable regulatory requirements. Please let us know if you would like to discuss the this requirement or available accommodations before proceeding with our recruitment process.

Bilingual (English-Spanish) candidates encouraged to apply.

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 preferred.
  • Prior clinical experience preferred.

What is a Must Have?

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

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 and resources that empower you to achieve your wellness goals. In addition, our Life Balance program provides access to professional counseling services, life coaching and other resources to support your daily life needs. Through Life Balance, you're eligible for five free counseling sessions with a licensed therapist.
  • 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. 


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/.


About Travelers

The Travelers Companies, Inc. (NYSE: TRV) is a leading property casualty insurer selling primarily through independent agents and brokers. The company's diverse business lines offer its global customers a wide range of coverage in the auto, home and business settings. A component of the Dow Jones Industrial Average, Travelers has more than 30,000 employees and generated revenues of approximately $25 billion in 2010.