RN Senior Medical Case Manager — Hybrid & Return-to-Work

Intact Insurance U.S.; Englewood (CO); Hybrid; USD 88,000 - 124,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

401(k) plan with up to 12% annual ifem

Job summary

Intact Insurance Specialty Solutions is seeking a Senior Medical Case Specialist to join our Specialty Recovery Claims team. The role, based in multiple U.S.

offices with a hybrid schedule, focuses on telephonic medical case management, coordinating return‑to‑work and medical plans for disability and medical treatment claims. You will review cases, communicate with employers, injured employees, providers and claims professionals, and ensure compliant, efficient care across 46 states we operate

Qualifications

• RN licensure is required.
• 5–7 years telephonic case management experience.
• Two+ years experience in workers' compensation.
• Familiarity with URAC standards.
• Experience understanding policies and contracts in workers' compensation.

Responsibilities

• Advocate to support, educate, guide and coordinate care for injured workers.
• Coordinate with medical providers to ensure participation in prescribed treatment plans.
• Identify providers and facilities to ensure timely, cost‑effective care within state rules.
• Act as point of contact for injured workers and address care questions.
• Facilitate clear communication among insureds, providers, workers, and claims adjusters.
• Maintain accurate case records per policies and regulatory standards.
• Prepare and submit progress and outcome reports to claims adjusters and management.
• Monitor telehealth follow-ups to assess recovery and return-to-work readiness.
• Develop strategies to maximize medical improvement and return‑to‑work timelines.
• Evaluate medical treatment requests against jurisdictional guidelines.
• Participate in quality improvement to enhance service delivery and outcomes.
• Collaborate with claim adjusters across the Claims organization.

Skills

Telephonic case management

Workers' comp experience

URAC standards

RN licensure

Education

RN licensure

Job description

Intact Insurance Specialty Solutions is seeking a Senior Medical Case Specialist to join our Specialty Recovery Claims team. The role, based in multiple U.S.

offices with a hybrid schedule, focuses on telephonic medical case management, coordinating return‑to‑work and medical plans for disability and medical treatment claims. You will review cases, communicate with employers, injured employees, providers and claims professionals, and ensure compliant, efficient care across 46 states we operate