Nurse Case Manager

Chesapeake Employers' Insurance Company

Chesapeake Employers' Insurance Company is a purpose-driven organization dedicated to improving the lives and livelihoods of our policyholders, injured workers, team members, and the community. As a leading workers' compensation specialty insurer in the mid-Atlantic region, we take pride in being a force for good. Our 350 team members are committed to making a positive impact every day in the lives of all our stakeholders. Join our motivated, professional team as we foster a culture of values, teamwork, innovation, and collaboration. Established in 1914, Chesapeake Employers Insurance, headquartered in Towson, Maryland, has over a century of experience, a strong financial foundation, and an "A" rating from AM Best.

Position Summary

Supports the claims adjuster's management of files through application of medical expertise and case management principles by coordinating medically necessary and cost-effective medical treatment and services with a focus on an early and safe return to work.

Duties and Responsibilities

• Initiates injured worker, attorney, health care provider and employer contacts within protocols.
• Develops, implements and manages the medical and disability plans, and initiates appropriate and timely case management interventions.
• Implements and coordinates services with the injured worker, family and health care providers during case management phase and documents all case management activity.
• Obtains necessary information for purposes of facilitating the treatment plan and managing case progression.
• Authorizes medically necessary, evidence-based and cost-effective treatment.
• Coordinates services and resources necessary to expedite return to work.
• Acts as a resource by review of claims with all relevant parties, such as Claims, Health Services and Legal.
• Utilizes and monitors preferred vendors for select services to ensure prompt, cost effective service.
• Follows established precertification and utilization review policies and protocols.
• Acts as medical resource to peers, claims and legal personnel.
• Supports Health Services Departments to ensure optimal service delivery to all customers.
• Provides specialized case management services such as catastrophic case management or similar type roles.
• Pursues and participates in continual educational activities for self-development and in meeting all regulatory requirements.
• Responsible for delivery of customer service, exceeding expectations.

Skills, Education and Experience

• Maryland RN License required.
• Bachelor's Degree (BSN) preferred.
• Case management/utilization review experience preferred.
• Prior workers' compensation case management experience preferred.
• 3-5 years' experience in nursing.
• Workers Compensation Case Management (WCCM) and Maryland Certified Rehabilitation Service Practitioner (MCRSP) certification preferred.
• Certified Case Manager (CCM) preferred.
• Strong interpersonal skills.
• Familiarity with Windows, Word and Excel.

Positional Competencies

• Bias for Action
• Knowledge Sharing
• Deliver Results
• Service and Sales Excellence
• Personal Leadership
• Teamwork and Communication

Physical Demands

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel objects, tools or controls; and reach with hands and arms. The employee is occasionally required to stand, walk, stoop, kneel, crouch or crawl. The employee may occasionally lift up to 30 pounds. Specific vision abilities required include close vision, peripheral vision and the ability to adjust focus.

Work Environment

Office environment. The noise level is usually moderate.

What We Offer

We offer a competitive benefits package that includes health, vision, and dental coverage, a robust PTO plan, an 8% employer contribution to retirement regardless of team member contribution, educational assistance, and opportunities to participate in team member appreciation events. Additionally, we provide STD, LTD and group life insurance 1X a team members salary. You'll also enjoy free tickets to community attractions, all part of our commitment to providing a high quality of work life. You will have the flexibility to thrive in a hybrid work environment and an opportunity to participate in development and volunteer programs.