Nurse Case Manager (Finance)

Division or Field Office:

Claims Division
Department of Position: Corporate Claims Department
Work from:
Home in ERIE's Footprint Salary Range:
$67,958.00-$108,556.00*

salary range is for thislevel and may vary based on actual level of role hired for

*This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location, and experience of an applicant, as well as level of role for which the successful candidate is hired.Position may be eligible for an annual bonus payment.

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia.

Benefits That Go Beyond The Basics

We strive to be Above all in Service® to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including:

• Premier health, prescription, dental, and vision benefits for you and your dependents.Coverage begins your first day of work.
• Low contributions to medical and prescription premiums.We currently pay up to 97% of employees' monthly premium costs.
• Pension.We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service.
• 401(k) with up to 4% contribution match.The 401(k) is offered in addition to the pension.
• Paid time off.Paid vacation, personal days, sick days, bereavement days and parental leave.
• Career development.Including a tuition reimbursement program for higher education and industry designations.

Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year.

Position Summary

Regularly exercises independent discretion and judgment in the coordination and management of the medical and disability process. Provides medical and rehabilitation consultation and education to claims personnel.

• The successful candidate will work from home and reside in ERIE's Footprint.
• Occasional travel for meetings, training, etc will be required.
• The successful candidate strongly preferred to have a PA/WV/MD license or they must obtain one within 90 days of their start date.

Duties and Responsibilities

• Coordinates the injured workers' medical treatment to ensure both cost effective and medically appropriate care is provided.
• Identifies inappropriate, experimental, overutilization or costly medical treatment.
• Facilitates the return to work process by acting as a liaison between the insured, medical provider, injured worker and the claims handler. Prepares job analyses and obtains medical clearance for return to work.
• Provides the claims handler with appropriate disability timeframes through the utilization of the Official Disability Guidelines.
• Coordinates treatment plans for cases involving catastrophic injuries and complicated medical conditions.
• Questions the causal relationship between the treatment and injury claimed.
• Assists in identifying and evaluating providers and managed care vendors.
• Oversees Vocational Rehabilitation activities in collaboration with the claims handlers.
• Proactively manages and controls expenses through utilization of Erie's cost containment vendors.
• Prepares medical cost projections and makes reserve recommendations upon request.
• Provides medical education and guidance to claims handlers on complex files.
• Maintains current knowledge of medical and rehabilitation trends.

The first sixduties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.

This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.

Competencies

• Values Diversity
• Self-Development
• Nimble Learning
• Collaborates
• Customer Focus
• Cultivates Innovation
• Instills Trust
• Optimizes Work Processes
• Ensures Accountability
• Decision Quality

Qualifications

Minimum Educational Requirements

• High school diploma, or GED, required.
• Current unrestricted Registered Nurse (RN) license in the state where the position is based and other assigned states as required by law.
• Bachelor of Science in Nursing (B.S.N.) and Certified Case Manager (C.C.M.) preferred.

Additional Experience

• Three years experience in case management involving workers' compensation claims preferred.
• Five years clinical nurse experience with a preference for previous Orthopedic, Emergency Room, or Critical Care experience preferred.
• Incumbent must live in region assigned unless a change is approved by the company.

Designations and/or Licenses

• Valid driver's license and good driving record required.

Physical Requirements

• Lifting/Moving 0-20 lbs; Occasional (<20>
• Lifting/Moving 20-50 lbs; Occasional (<20>
• Ability to move over 50 lbs using lifting aide equipment; Occasional (<20>
• Driving; Occasional (<20>
• Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20>
• Manual Keying/Data Entry/inputting information/computer use; Frequent (50-80%)
• Climbing/accessing heights; Rarely

Nearest Major Market: Erie