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Utilization Management Team Work

Adjuster - Facilitates administrative aspects of the case

  • Accurate and timely determination of compensability
  • Timely and accurate distribution of indemnity benefits
  • Overall claims costs including communication with the medical community

Nurse Case Manager - Facilitates medical care

  • Acts as a resource for the injured worker and their family
  • Assists in selection of a provider from the network that is appropriate for the injury
  • Interprets medical information
  • Begins the Return to Work process
  • Maintains communication with all involved parties

Team Work - The Nurse Case Manager, the Adjuster, the Provider, and the Employer work together, resulting in positive outcomes for the employer and employee.