Case Manager - Workers' Compensation
Tower Group Companies - Chicago, IL

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GENERAL SUMMARY To support the Enterprise in the medical management of Workers Compensation claim exposures. Provide Nurse Case Management Services where value added on specific claim exposures; with an emphasis on Early Intervention, Return to Work Planning, and coordination of medical care on claims involving disability and medical treatment. Support Claim Examiners in the management of medical issues on specific claim exposures. Mentor, train and educate local Claim

Examiners on medical terminology and practices. Provide Customer Support as necessary on medical management issues, interacting with internal and external customers.

¨ Education · Bachelors Degree in Nursing, Healthcare or Occupational Medicine required · Active RN license required for assigned jurisdictions, as well as state specific registrations or certifications as required be assigned jurisdictions · Certified Case Manager (CCM), Certified Disability Management Specialists (CDMS), Certified Rehabilitation Registered Nurse (CRRN), and/or Certified Occupational Health Nurse (COHR), professional designations desired . ¨ Experience · 3 – 5 years of Managed Care Services Industry experience required § Similar Health Care Industry experience will be considered · Experience in Managed Care Services oversight and/or implementation within the Commercial and/or Personal Insurance Industry a plus · Experience in on-site nursing fields a plus ¨ Skills · Knowledge regarding relationship of Managed Care Services to Property & Casualty Insurance claim services · Excellent analytical skills · Accuracy and attention to detail · Problem solving · Strong interpersonal and communication skills · Ability to work independently and within a team environment · Ability to function effectively within an ever-changing environment to meet deadlines and reprioritize as necessary · Proficiency in MS Office (Excel, Word, Powerpoint, Project) and data warehouse utilization

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