W. R. Berkley Corporation

Manager

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Workers Compensation Telephonic Nurse Case Manager

• Assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers
• Coordinate and implement medical case management to facilitate case closure
• Timely and comprehensive communication with employers, adjusters and the injured workers
• Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
• Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
• Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
• Acquire and maintain nursing licensure for all jurisdictions as business needs require
• Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
• Document activities and case progress using appropriate methods and tools following best practices for quality improvement
• Reviewing job analysis/job description with all providers to coordinate and implement disability case management
• Engage and participate in special projects as assigned by case management leadership team
• Occasionally attend on site meetings and professional programs
• Foster a teamwork environment
• Maintaining and updating evidence based medical guidelines in reference to the injured worker treatment plan and work status
• Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed
• Obtain case management professional certification (CCM) within 2 years of hire date
• Earn Continuing Education Units to maintain certifications and licensures

Telephonic Nurse Case Manager

Recruitment

• Coordinating candidate interviews and travel
• Managing candidate onboarding activities including background verifications and other assessments
• Identifying and implementing alternative sourcing and staffing solutions as needed
• Managing external agency relationships and contracts as needed for the team
• Interfacing with third party vendors as needed to expedite candidate onboarding and hiring
• Participating on search kickoff/intake calls and interview prep/debrief sessions with Hiring Managers, HR Partners, and Talent Acquisition Partners
• Creating and placing compelling job advertisements on internal/external job boards
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• Collaborating with corporate and operating unit marketing colleagues to develop state-of-the-art job posting formats.
• Reviewing and assessing candidate resumes and managing candidate correspondence.

Talent Acquisition Coordinator

Claims Specialist

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• Collaborate with vendors to ensure timely appraisal and evaluation of damages
• Analyze coverage by applying policy information to facts or allegations of each loss
• Maintain discipline in securing and updating information throughout the life of the claim
• Establish and maintain appropriate loss and expense reserves
• Investigate each claim through prompt and strategic contact with appropriate parties
• Evaluate, negotiate, and settle assigned claims within authority granted
• Develop litigation plan with defense or coverage counsel
• Collaborate with internal teams to ensure a comprehensive understanding of the claims process

Senior Claims Specialist

• Maintain claims standards while supporting business strategy initiatives
• Adjust Cargo claims of assigned severity
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• Manage complex Cargo claims
• Provide quality customer service and communication
• Analyze and interpret policy language for coverage decisions
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Workers Compensation Telephonic Nurse Case Manager

Telephonic Nurse Case Manager

Talent Acquisition Coordinator

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