CARE: A Four Letter Word for Simplifying WC System Complexities
Terri Riley
Senior Vice President, Managed Care Practices and Client Services, Careworks
In this podcast episode, we have a discussion on simplifying the complexities of the workers' compensation system with Terri Riley. Terri emphasizes the centrality of care for injured employees, focusing on their safety, job security and health. She discusses the challenges in medication delivery, the necessity of crisis care management for public entities and first responders, and the streamlining of claims management processes. Terri also addresses the rising costs in workers' compensation and the role of managed care in controlling these costs and aiding return-to-work efforts.
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Terri Riley
Senior Vice President, Managed Care Practices and Client Services, Careworks
Summary of Qualifications
Terri has nearly 25 years’ experience in major account management, most of which has been specific to managed care services and related programs. As part of the Careworks team, she is committed to helping injured employees get back to health, work and productivity, all while positively impacting claims outcomes.
Responsibilities
In her current capacity, Terri is responsible for national managed care best practices, assuring operational and regulatory accuracy both internally and with our business partners. She has national oversight of managed care product development, major account client services, marketing and communications, and product training. She applies analytical skills for identifying potential cost-savings areas, project implementation management and complex problem-solving.
Business Experience
Terri has extensive experience with developing and growing managed care products, promoting services to brokers and clients, and evolving client programs from implementation into long-term successful partnerships. She has specialty expertise in ancillary services, including bill review, case management, utilization review, regulatory compliance and vendor partnerships. Her background includes managed care program management, implementation project management, creative program design and program training.
Professional Affiliations
Terri is a member of Risk & Insurance Management Society and Mid-South Workers Compensation local chapters, and is the TN Ambassador for the Alliance of Women in Workers' Compensation. She currently sits on the executive board of Leadership Memphis, having also receiving certificates of graduation from their executive programs, and co-leader for the West TN chapter of Kids’ Chance. Terri frequently speaks at national industry conferences, client meetings and training sessions.
Education
Terri has a Bachelor of Science in business administration. She has continued her academics through programs offered by the Insurance Institute of America and American Management Association.
