A CAREER THAT STARTED FROM AN AD IN THE PAPER:  Mollie originally was an elementary school teacher with a Master’s Degree in counseling. While she loved being a teacher, she wanted something more. She entered into the Worker’s Compensation Community when she became a counselor for injured workers. Her career in case management started, when she saw an ad in the paper for Intracorp, one of the first companies that utilized case management. She found her passion in case management, and loved what she was doing. She loved speaking with doctors, injured workers, and adjusters. In 2007, she started her own case management company. She started in her home office as the only employee, but in almost fifteen years, has grown her network to over five hundred employees.  The grand design was not to own a case management company, but life takes people in very strange twists and turns.

SHE WANTED HER COMPANY TO BE DIFFERENT:  The main differentiator is that all of her case managers have a minimum of seven to ten years’ experience. She hires people that are like herself, and have a footprint in the worker’s compensation community. She wants case managers that know how to obtain great results, and treats them as a partner. She understands how hard case management can be, due to her extensive experience in case management.  

CASE MANAGERS ARE THE CONNECTOR BETWEEN ALL THE DIFFERENT TEAM MEMBERS: She describes case management as a Venn Diagram, with all the team members. There are several team members involved in a claim such as the injured worker, adjuster, physical therapist, risk manager, nurse case manager, attorney, and sometimes multiple providers. If the claim has multiple providers, likely, they are not communicating with each other regarding treatment and medications, and this can cause confusion and delay.  The most important team member is the injured worker, and it is crucial to use empathy, and make sure they are getting the best care. The role of the case manager is to intersect with all the team members, make sure everyone is aware of what is going on, and move the claim in a positive direction.

THE DIFFERENT TYPES OF CASE MANAGEMENT: Telephonic Case Managers help coordinate everything on the claim, such as appointments, physical therapy, obtaining medical records telephonically, and keeping the adjuster updated.  Field Case Managers go to doctors’ appointments and speak with the doctor and injured worker, obtain medicals, and are the “eyes and ears” for the adjuster. The case manager can physically see the injury, swelling, limping, and any other issues that may impact the claim. They can discuss the injured worker’s job description with the doctor, and obtain restrictions for the injured worker, so they can return to work in a light duty position. If the claim is a “Catastrophic Claim,” where an injured worker has suffered a very serious injury, there are several things that need to be coordinated. The case manager needs to coordinate discharge to rehabilitation facilities, ordering durable medical equipment (DME), coordinating home modifications, doctor’s appointments (sometimes with several different specialists), transportation, and providing education to the injured worker and their families. Gaining the trust of the injured worker, and their families, is the most crucial component in this role.

MISTAKES HAPPEN; TAKE OWNERSHIP:  If a mistake is made by a case manager, she will take ownership, and make it right. She will drill down, and find out what happened, and learn from it. There are times when referrals are turned down, because it will not benefit her customers. Sometimes the travel time doesn’t make sense, or the case manager that is available, is not the right fit for the claim. By being transparent, it builds trust with her customers. Honesty is always the best policy.

THE DIFFERENCE BETWEEN “GOOD” AND “AMAZING”:  An amazing case manager is proactive instead of reactive. They look ahead, and can anticipate potential challenges. They have conversations with the adjuster, and keep them updated after each appointment, and offer ideas on how to move the claim in a positive direction.  An amazing case manager builds trust with the adjuster, and can think outside the box. A great example of this, is when an injured worker was going to be kept in the hospital over the weekend, due to the hospital could not obtain a knee walker until Monday. Mollie googled knee walkers, and found a provider who could provide one right away, so the injured worker could go home.  

THE GREATEST PART OF CASE MANAGEMENT: She loves working with the case managers, and tackling difficult issues, and bringing synergy to claims. When you have an injured worker who was injured and hospitalized in one state, but lives and treats in another, communication between case managers has to be clear, and concise. When it works, it is like a “symphony.” She recalled being at a meeting, and an injured worker who had survived a catastrophic injury, was speaking about how case management made such a difference in his recovery. When you can make a difference in someone’s life, these are the moments that are the most rewarding.