Senior Medical Case Manager – Telephonic Workers' Comp

Intact Insurance Specialty Solutions; Englewood (CO); Hybrid; USD 88,000 - 124,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Paid time off

401(k) with 12% contributions

Mental health support programs

Life and disability insurance

Parental leave

Voluntary benefits

Job summary

Intact Insurance Specialty Solutions is hiring a Senior Medical Case Specialist for our Specialty Recovery Claims team. The role is hybrid and supports telephonic case management across multiple U.S.

offices, coordinating care for injured workers and facilitating return-to-work plans. You will operate with 5–7 years in case management (2+ years in WC), using URAC standards and policy knowledge to assess treatment requests, communicate with providers, and document progress for claims

Qualifications

• Current and valid RN license required.
• 5–7 years of telephonic case management experience, with 2+ years in workers' compensation.
• Familiarity with URAC standards.
• Experience understanding policies and contracts as they apply to policy conditions.

Responsibilities

• Provide telephonic medical case management, coordinating care between employers, employees, providers and claims professionals.
• Facilitate communication to support return-to-work and medical care plans.
• Review medical treatment requests to ensure compliance with jurisdictional guidelines.
• Maintain case records in line with regulatory standards and company policies.
• Submit reports on case progress to claims adjusters, insureds and management.
• Support quality improvement initiatives to enhance service delivery.

Skills

Telephonic case management

Workers' compensation knowledge

URAC standards

Policy interpretation

Education

Registered Nurse (RN) license

Job description

Intact Insurance Specialty Solutions is hiring a Senior Medical Case Specialist for our Specialty Recovery Claims team. The role is hybrid and supports telephonic case management across multiple U.S.

offices, coordinating care for injured workers and facilitating return-to-work plans. You will operate with 5–7 years in case management (2+ years in WC), using URAC standards and policy knowledge to assess treatment requests, communicate with providers, and document progress for claims