Workers' Compensation Nurse Case Manager
The Cincinnati Insurance Companies - Fairfield, OH

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The Cincinnati Insurance Company, a subsidiary of Cincinnati Financial Corporation, stands among the nation’s top 25 property casualty insurer groups, based on direct written premiums. Our commitment to the independent agency system began in 1950 and is our company’s core strength and competitive advantage. We excel by offering agents and policyholders a local presence, unparalleled claims service, loss control consultation services, work-saving technology initiatives, and competitive products, rates and compensation.

The medical resources unit for our Headquarters Claims department seeks two early intervention nurse case managers.

Responsibilities:

- provides clinical support for file claim handlers and headquarters staff to ensure optimal case management
- maintains accurate documentation in claims management system
- communicates with case management organizations and coordinates referrals
- documents file assignments and directions with high attention to detail
- assists with coordination of services with specialty vendors
- maintains accountability of the case management coordination and collaboration of the early intervention team
- supports efforts of early intervention clerical staff
- strives for data accuracy and consistency
- provides oversight for catastrophic and complex medical claims
- participates in claim case conferences
- pursues continuing education to remain current and attain expertise relevant to job duties

Skills:

- knowledge of Microsoft Outlook, Word, Excel and Adobe
- experience with research and interpreting medical guidelines
- catastrophic and complex medical care claims management experience
- understanding of workers' compensation jurisdictional key differentiators
- experience with vocational case management efforts/services
- understanding of principals and can execute a job analysis
- familiar with components of achieving best outcomes with telephonic and field case management services
- experience with utilization review processes
- knowledge of workers' compensation managed care programs and initiatives
- familiarity with URAC standards and expectations

Education/Experience:

- RN required
- BSN preferred
- two or more years of workers' compensation field case management experience
- CCM or other URAC-recognized designations
- licensed in Ohio (preferred) in good standing, with no prior or pending infractions

Qualities:

- strives to provide excellend customer service to internal and external customers
- shows initiative in assisting other team members
- masters principles and strategies for maintaining professional and respectful relationships with all stakeholders
- demonstrates strong time management skills and ability to prioritize work
- maintains electronic data and other known sensitive information with the utmost confidentiality
- takes on new responsibilities as needed
- always striving to improve industry knowledge

Other:

Selected associates receive a comprehensive salary and benefits package, including a matching 401(k). Equal Opportunity Employer.


Indeed - 17 months ago - save job - block
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