We’re committed to putting people first – if you need an accommodation as you go through the job searching, application, and interviewing process, please click here for more information.
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Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements. Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome. Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries. Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy. Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner. Accurately and appropriately documents billable time for work performed. Achieves annual chargeable time goal. Handles special projects as assigned. May conduct in-person visits on assigned cases with injured employees, medical professions and the employer to assess medical recovery, physical capabilities, RTW barriers, physical job requirements, modified duty opportunities. * Ability to analyze and make sound nursing judgments and to accurately document activities. Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others. Good negotiation skills to effectively establish target return to work dates and coordinate medical care. Knowledge of state, local and federal laws related to health care delivery preferred. Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook). Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing). Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience. Previous medical case management experience a plus. Must also have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law. Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by WC law. 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Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill required", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": "remote_local", "canonicalPositionUrl": "https://searchjobs.libertymutualgroup.com/careers/job/618505446036", "isPrivate": false, "latlongs": "37.09024,-95.712891"}, {"id": 618504978537, "name": "Claims Specialist - Workers Compensation - West Region", "location": "Anaheim, California, United States", "locations": ["Anaheim, California, United States", "Anchorage, Alaska, United States", "Orange, California, United States", "Sacramento, California, United States", "Los Angeles, California, United States", "Chandler, Arizona, United States", "Portland, Oregon, United States", "Honolulu, Hawaii, United States", "Las Vegas, Nevada, United States"], "hot": 0, "department": "Claims", "business_unit": "3026-GRS-North America-US", "t_update": 1752256680, "t_create": 1750117860, "ats_job_id": "70788", "display_job_id": "2025-70788", "type": "ATS", "id_locale": "2025-70788-en", "job_description": "Manages an inventory of claims to evaluate compensability/liability. Establishes action plans based on case facts, best practices, protocols, regulatory issues, and available resources. Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate. Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. Performs other duties as assigned. Effective interpersonal, analytical and negotiation abilities required Ability to provide information in a clear, concise manner with an appropriate level of detail Demonstrated ability to build and maintain effective relationships Demonstrated success in a professional environment; success in a customer service/retail environment preferred Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory Licensing may be required in some states", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": "onsite", "canonicalPositionUrl": "https://searchjobs.libertymutualgroup.com/careers/job/618504978537", "isPrivate": false, "latlongs": "33.8365932,-117.9143012"}, {"id": 618505125572, "name": "Complex Casualty Claims Specialist - Northwest Region", "location": "Remote, Remote, United States", "locations": ["Remote, Remote, United States", "Liberty Lake, Washington, United States", "Chandler, Arizona, United States", "Plano, Texas, United States"], "hot": 0, "department": "Claims", "business_unit": "3003-USRM-Claims & Service-US", "t_update": 1750946100, "t_create": 1750758000, "ats_job_id": "70934", "display_job_id": "2025-70934", "type": "ATS", "id_locale": "2025-70934-en", "job_description": "Works autonomously within prescribed authority limits. Manages, investigates, and resolves auto and homeowner's casualty claims. Investigates and evaluates coverage, liability, damages, negotiates and settles claims and manages litigation within prescribed procedures and authority. Provides analysis and recommends strategy and resolution plans on assigned cases in excess of their authority level to local claims management and Home Office. Identifies potentially suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Prepares for and attends mediations, settlement conferences, trials and hearings and reports to Home Office and local management on status. Confers with trial counsel and prepares trial reports. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advises as to proper course of action. Responds to various written and telephone inquiries, prepares status reports. Ensures adequacy of reserves. Recommends reserve changes on cases in excess of authority. Accountable for security of financial processing of claims, as well as security of information contained in claims files. Responsible for partnering with outside and in-house counsel on defense strategies. May assist in the absence of the Claims Manager, representing the company on matters involving state or federal regulatory agencies. May be involved in special projects and/or mentoring at the direction of local management. 5+ years of litigation experience Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Must have an expert knowledge of coverage, liability, and complex claims handling procedures. Must be able to effectively handle claims at the highest technical and complexity level. Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. 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Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status. Confers with trial counsel and prepares trial reports. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. Accountable for security of financial processing of claims, as well as security information contained in claims files. Responsible for managing the practices and billing activities of outside and in-house counsel. May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies. May be involved in special projects and/or mentoring at the direction of local management. 5+ years of litigation experience Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Must have an expert knowledge of coverage, liability, and complex claims handling procedures. Must be able to effectively handle claims at the highest technical and complexity level. Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. A full working knowledge of claims operations and procedures is required. 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#advanced_menu_toggle{position:absolute;border-radius:2px;height:46px;width:46px;line-height:46px;text-decoration:none;text-align:center;right:0;top:50%;margin-top:-23px;z-index:10000;border-style:solid;border-width:1px;font-size:30px;display:none;} @media only screen and (max-width: 989px){.responsive.html_mobile_menu_tablet .main_menu .avia-menu{display:none;} .responsive.html_mobile_menu_tablet .container #advanced_menu_toggle{display:block;} } @media only screen and (max-width: 767px){.main_menu .avia-menu{display:none;} .container #advanced_menu_toggle{display:none;} } } @media print{a,strong{color:black!important;} a{text-decoration:underline;} .container{width:100%;} .container{width:100%;margin:0 auto;} #header_main{border-bottom:0;} nav{display:none;} } @media all{::selection{background-color:#002663;color:#ffffff;} .header_color div,.header_color nav,.header_color span,.header_color a,.header_color img,.header_color strong,.header_color ul,.header_color li{border-color:#1a1346;} .header_color a,.header_color strong,.header_color strong a{color:#1a1346;} .header_color a:hover{color:#1a1346;} .header_color .avia-menu-fx,.header_color .avia-menu-fx .avia-arrow{background-color:#1a1346;color:#ffffff;border-color:#080124;} .header_color .avia-bullet{border-color:#1a1346;} .html_header_top .header_color .main_menu ul:first-child >li > ul{border-top-color:#1a1346;} .header_color .main_menu ul ul,.header_color .main_menu .menu ul li a{background-color:#fecf00;color:#1a1346;} .header_color .main_menu .menu ul li a:hover{background-color:#fecf00;} .header_color .main_menu ul:first-child > li > a{color:#1a1346;} #top .header_color .main_menu .menu ul li>a:hover{color:#1a1346;} .header_color .main_menu ul:first-child > li a:hover,.header_color .main_menu ul:first-child > li.current-menu-item > a,.header_color .main_menu ul:first-child > li.current_page_item > a{color:#1a1346;} #advanced_menu_toggle{background-color:#fecf00;color:#1a1346;border-color:#1a1346;} .avia_desktop #advanced_menu_toggle:hover{background-color:#1a1346;color:#ffffff;border-color:#1a1346;} .header_color .avia-arrow{background-color:#fecf00;} .header_color .avia-bullet{border-color:#1a1346;} #top .header_color a:hover .avia-bullet{border-color:#1a1346;} .container{width:100%;} .responsive .container{max-width:1260px;} #top #header .av-main-nav > li > a{font-size:14px;} } @media all{.WCAG-2-A{display:none!important;} @media (max-width: 767px){::-webkit-scrollbar{-webkit-appearance:none;} ::-webkit-scrollbar-thumb{background-color:rgba(0, 0, 0, .5);border-radius:10px;} ::-webkit-scrollbar-track{border-radius:10px;background-color:#ffffff;} } } @media all{*:focus{outline:1px dotted #808080!important;outline-offset:-2px!important;} .header_color .main_menu ul:first-child>li>a{color:#1a1446;font-family:'roboto-bold';font-size:16px!important;} .html_main_nav_header.html_logo_left #top .main_menu .menu>li:last-child>a{padding-right:13px;} .header_color .main_menu ul:first-child>li>a:hover{background:rgba(255, 255, 255, 0.8)!important;} .menu-item-has-children:hover{background:rgba(255, 255, 255, 0.8);} .main_menu .avia-menu-fx{display:none;} .main_menu .current_page_item a .avia-menu-text{border-bottom:1px solid #1a1446;padding-bottom:6px;} .main_menu .sub-menu,.main_menu .sub-menu li a{background-color:rgba(255, 255, 255, 0.7)!important;border:0;font-size:14px!important;font-family:'roboto-bold'!important;} .main_menu .sub-menu li a:hover{background-color:#e8e8e8!important;} .main_menu li.dropdown_ul_available>a{padding-right:30px!important;} .main_menu li.dropdown_ul_available>a::after{font-family:FontAwesome;position:absolute;left:auto;margin:0 5px;font-size:12px;} .main_menu li.dropdown_ul_available>a:hover::after{} #header_main{border:none;background-color:#ffd000;} .logo img{width:250px!important;margin-top:10px;} @media screen and (max-width:989px){#advanced_menu_toggle[data-av_icon]:before{font-size:30px;font-weight:normal;font-family:'FontAwesome'!important;} #advanced_menu_toggle{border-width:0px;} .container{padding:0 30px;} .responsive .logo{padding-top:10px;} } .main_menu .current_page_item a .avia-menu-text{border-bottom:0!important;} @media screen and (max-width:767px){.rem-arrow a:before{content:' '!important;} .responsive #top #wrap_all .container{width:92%;max-width:92%;} #advanced_menu_toggle{left:0;right:auto;border-width:0px;} .responsive #top .logo{margin:0 auto;width:150px;} .responsive .logo img{max-height:40px;margin:0 auto!important;} #header_main{border-top:0;} } @media screen and (min-width:1024px){li#menu-item-13649 ul.sub-menu{left:207px!important;} li#menu-item-13649.dropdown_ul_available>a::after{font-family:FontAwesome;position:absolute;left:auto;margin:0 5px;font-size:10px;} } #top a:focus{outline-offset:-2px!important;opacity:1!important;} .inner-container a:focus{outline-offset:-5px!important;} @media screen and (min-width:768px) and (max-width:1024px){.header_color .main_menu ul:first-child>li>a{font-size:12px!important;} } #top .main_menu .av-main-nav ul ul{border:0!important;padding-top:0px;position:static;display:block!important;border-bottom:1px solid #000!important;overflow:hidden;background-color:transparent!important;} #top .main_menu .av-main-nav ul ul li a{padding-left:35px;font-size:12px!important;padding-top:5px;padding-bottom:5px;background-color:rgba(255, 255, 255, 0.7)!important;} #top .main_menu .av-main-nav ul ul li a:hover{background-color:rgba(232, 232, 232, 0.7)!important;} .av-main-nav ul li:last-child>a{border:none!important;} #top .main_menu .av-main-nav ul ul{border-bottom:0px solid #000!important;} } .navbar{display: none!important;} .logo{padding-right:60px!important;} #menu-item-973:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-11981:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-1136:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-1435:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-3937:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} #menu-item-12966:hover{background-color:rgba(255, 255, 255, 0.8) !important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} .fa-brands{-webkit-font-smoothing: antialiased; font-style: normal; font-variant: normal; line-height: 1; text-rendering: auto;font-family: 'Font Awesome 6 Brands'} .position-details li{list-style-type: disc;} .header-wrapper{display:none!important;}.disability p {text-align:center!important;background-color:#F0F0F0!important; height:45px!important;padding-top:12px!important;} .disability a {color:blue!important;text-decoration:underline!important;} @media only screen and (max-width: 1325px){.disability p {height:67px!important;}} @media only screen and (max-width: 675px){.disability p {height:92px!important;}} @media only screen and (max-width: 480px){.disability p {height:114px!important;}}h4{margin-top: 5px;font-weight: 600;}