This is a work from home position requiring local field case management travel
To provide quality case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and CMSA Standards of Practice and Quality Improvement Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers' Compensation, Group Health, Liability and Disability.
Bachelor’s degree in a health-related field is required.
Three years of Workers’ Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity.
Valid RN licensure in the state(s) the incumbent works in.
Minimum of 1 nationally recognized Certification from the URAC list of approved certifications.
Must be able to travel as required.
Individuals who conduct initial clinical review possess an active, professional license or certification:
Think all TPAs are the same? Think again. With Broadspire, our leading global third-party administrator (TPA), Crawford & Company is the consultative outsourcing partner that adapts to businesses’ needs and challenges at any point of the claims processing journey. We offer casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics.
As part of the One Crawford family, Broadspire brings together the best and brightest people in the industry to deliver smart, thoughtful solutions to our clients, and we are guided by our collective value system: RESTORE.
At Crawford, we:
We believe in leading by example – at work and in our communities. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in mission, vision and values. Learn more at www.crawfordandcompany.com.
In addition to a competitive salary, Crawford offers you:
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.