Medical Case Management

Medical Case Management

Our first priority is always to ensure that an injured employee quickly receives the most appropriate treatment. Once treatment is obtained, our job is to monitor and manage the care of the injured employee. We have learned that the sooner a professional nurse case manager becomes involved, the better the outcome for both the employee and the employer.

The nurse case manager is a nurse who is certified in occupational health and is also a certified case manager who facilitates and coordinates medical treatment and a safe return-to-work process for the injured employee. This coordinated personalized approach benefits injured workers and helps to hold down claims costs.

The claim director has ultimate control of each lost time claim and is responsible for performing a complete investigation, payment authorization, evaluation of the claim, including setting and monitoring reserves, negotiation, litigation management, subrogation, and second injury fund filings.