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Inside Managed Care Services:

Care Management

The Case Management Society of America defines case management as “a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality, cost-effective outcomes.” The EMPLOYERS® Care Management program is designed to meet this definition by focusing on the following services:

  • Healthcare professionals are assigned, when indicated, to specific cases based on the degree of the employee injury.

  • Healthcare professionals provide ongoing assessment and evaluation of injured employees' progress through the treatment-recovery process.

  • Utilization Review evaluates appropriate treatment based upon nationally accepted clinical guideline standards.

Many EMPLOYERS’ healthcare professionals work on site in collaboration with our Claims Examiners to provide assessment and evaluation of injured employees’ progress throughout treatment and recovery. Evaluation of treatment suitability is based on nationally accepted clinical guideline standards, and implementation of an injured employee’s overall care. EMPLOYERS’ nurses are available Monday thru Friday, 8 AM to 5 PM and have voicemail access 24 hours a day. Telephone messages are returned within one (1) business day. Messages can also be left with our Customer Service Center.