Premier Comp Management Team
The Premier Comp Management Team consists of the MCO Medical Director, MCO Director, Manager of RTW/Case Management, Manager of Business Development and Supervisor of Client Services.
MCO Medical Director
The Medical Director is responsible for oversight of the medical management of the MCO. Qualifications include licensure by the State of Ohio, practice experience and Board Certification in a specialty area related to Workers’ Compensation is preferred. The Medical Director recommends medical policy revision, advises the MCO regarding quality initiatives as the medical resource to Case Management staff, consults with providers and communicates with committees regarding provider, employer and injured worker issues.
MCO Director
The MCO Director is responsible for the overall supervision and management of all Premier Comp employees, operations and Case Management. The MCO Director will approve and review all Quality Assurance complaint and corrective action forms and Quality Assurance quarterly and annual reports.
Manager of RTW/Case Management
The Manager of RTW/Case Management is responsible for the overall supervision and management of clinical personnel, Case Management and return to work functions. This manager is responsible for overseeing all Case Management plans and implementing quality improvement processes for the Case Management staff.
Manager of Business Development
The Manager of Business Development is responsible for oversight of the Quality Assurance Program, URAC application, certification and maintenance of URAC Standards and policies and procedures. This manager is responsible for orientation and training of all new employees and the Case Management staff to comply with URAC Standards.
Supervisor of Client Services
The Supervisor of Client Services is responsible for overall supervision of operations and customer service.
Premier Comp Case Management
and Operations Team
The Operations Team seeks to support the organizational goal of quality through integrated decision making and problem solving efforts.
Quality Assurance Coordinator
The Quality Assurance Coordinator develops quality initiatives based on recommendations from the management and the committee structure through the evaluation of internal monitoring activities.
Outside Service Representative
The Outside Service Representative serves as the liaison between employers and Premier Comp and may provide claims reports. The Outside Service Representative assists in educating and updating employers on current events and policies mandated by BWC.
Case Manager
The Case Manager responsible for assessing, planning, implementing, coordinating, monitoring and evaluating claims throughout the life cycle to reach goal oriented outcomes. The Case Manager is ultimately responsible for the application of Case Management strategies across the continuum of care and for developing individualized, proactive, outcome focused action plans for injured workers.
Case Assistant
The Case Assistant is primarily responsible for reviewing all new claim files and identifying cases to be referred for case management services. The Case Assistant will gather all initial claim documentation for the Case Manager and assist with contacting the employer and providers for additional information.
Inside Service Representative
The Inside Service Representative is responsible for the general account services of all assigned Premier Comp employer groups. The First Report of Injury notification and basic claim handling are priorities and functions of this department.
Claims Analyst
The Claims Analyst is responsible for the overall claims adjudication process. The Claims Analyst use the prior authorizations entered by Case Managers and Case Assistants for appropriate claims approval and payment.