Position

The Claims Operations department has an immediate opening for someone who can demonstrate the WCF values to join their team as a Supervisor, Telephonic Case Management. This is a full-time, exempt, hybrid position that works out of WCF's Sandy, Utah headquarters. This posting is open to internal and external candidates.

Responsibilities

• Leads, mentors, and develops a team of TCMs and medical service specialists.
• Supports the MCM manager, conducts quarterly chats, and promotes career development for TCM staff.
• Train and coach team members in their responsibilities and ensure quality/timely work product.
• Analyze referrals submitted by adjusters to make appropriate referrals to team members.
• Apply medical policies, practices, and procedures for case determinations.
• Analyze medical records & clinical criteria to determine appropriate treatment & case direction.
• Obtain accurate information and document the case status.
• Identify and recommend referrals to Field Case Management as needed.
• Ensure compliance with TCM standards of practice and provide guidance to TCM on complex cases.
• Maintains strong working relationship with the Manager of MCM, other supervisors, and claims management.
• Remains objective and professional when balancing conflicting needs of injured workers, providers, and claims adjuster.

Qualifications

• Bachelor's degree in nursing or health-related field preferred.
• Graduate of an accredited RN program and current Utah license.
• At least one national certification, CCM or CRRN, or other as approved.
• Five years of clinical experience or equivalent combination of education and experience required.
• Strong background in telephonic or field case management.
• Thorough knowledge of workers' compensation claims and medical recovery process.
• Exceptional communication (verbal and written), time management, computer, and negotiation skills.
• Efficient multi-tasking and clinical prioritization.

WCF Insurance offers an extensive compensation package. Benefits include Medical, Dental, and Vision insurance, company paid life insurance, 401K with a generous 6% employer match and additional benefits such as an Employee Assistance Program (EAP) and time off to volunteer in the local community. All employees earn 4 weeks of vacation in their first year.

Internal candidates should have acceptable job performance, 6 months in their current position, and must notify their current supervisor that they have applied for the position.

Our People

WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive

WCF Insurance is an Equal Opportunity Employer

WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.