Carolina Case Management

What Carolina Case Management does

Carolina Case Management & Rehabilitation Services, Inc. is a privately held, family-owned medical case management firm headquartered in Raleigh, North Carolina, founded in 1995 by Nancy Wells. The company provides professional case management services for workers' compensation and disability claims, including field-based medical case management, vocational case management (assessment, transferable skills analysis, job analysis, return-to-work placement), short-term telephonic case management (typically 30–90 days), and specialized services such as long-term disability evaluations, loss of earning/earning capacity assessments, and IME coordination. Service is delivered through a network of field case managers across North Carolina, South Carolina, Virginia, Georgia, Kentucky, and West Virginia, supplemented by nationwide telephonic case management. The proprietary component of the offering is a copyrighted Digital Job Analysis Format (with optional Video Job Analysis) that documents objective work activities, essential functions, physical demands, and worker characteristics.

The customer base is primarily B2B and enterprise-oriented, consisting of insurance companies, self-insured employers, third-party administrators, attorneys handling workers' compensation and personal injury cases, and government entities. Multiple named clients (Discovery Insurance Company, BSI/SCA, Lodestar Claims, The Harper Law Firm, Younce, Vtipil, Baznik & Banks, P.A.) have worked with the firm since or near its inception, reflecting a high-touch, relationship-driven go-to-market executed through Regional Account Managers (Kara Faust, Josh Hines, Julie Abee), online referral forms, downloadable PDF referral forms, and active participation in industry associations (IARP, CMSA, NC/SCRIMS, RIMS chapters) and conferences. The company is also BBB accredited, a member of the Raleigh Chamber, and holds HUB / SWUC / SBE designations.

The revenue model is professional services: case management fees are negotiated per case or through service agreements with insurance carriers, self-insured employers, and TPAs, with no publicly disclosed pricing. A secondary revenue stream consists of continuing education courses offered to licensed adjusters for CE credits. The firm is bootstrapped with no disclosed funding rounds, no parent company, and no institutional investors; it has grown organically from 3 staff in 1995 to over 100 employees operating across multiple states and serving clients nationwide.

Name

Carolina Case Management

Legal name

Carolina Case Management & Rehabilitation Services, Inc.

Website

https://carolinacasemgmt.com

Company type

Private

Founded year

1995

Operating status

Operating

Headcount range

101–250 employees

Short description

Carolina Case Management is a family-owned, Raleigh-based professional services firm founded in 1995 that provides medical, vocational, and telephonic case management for workers' compensation and disability claims, serving insurance companies, self-insured employers, TPAs, and attorneys across the Southeast and nationwide.

Ownership category

akta.pro rank

Product category

Workers' Compensation Case Management Services

NAICS

Management Consulting Services (54161), Professional, Scientific, and Technical Services (54)

SIC

Services-Management Consulting Services (8742), Insurance Agents, Brokers & Service (6411)

akta.pro industry

PRIMARYEDAAAOAK

Workforce Support Services & Case Management (Coaching, Wraparound)

Education/Adult & Continuing Education/Workforce Development Initiatives

SECONDARYBPAHAAAM

Personal Injury & Insurance Defense

Business & Public Services/Professional Services (Legal, Accounting, Consulting)/Legal Services

Keywords

• Workers compensation case management
• Medical case management
• Vocational rehabilitation services
• Telephonic case management
• Disability claim management

Headquarters

HQ city

Raleigh

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D, Others

Revenue model

1. Case Management Services: Professional case management services including medical case management, vocational case management, telephonic case management, and specialized services for workers' compensation and disability claims.
2. CE Courses: Continuing education courses for licensed adjusters covering medical and vocational case management in workers' compensation claims.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Carolina Case Management provides professional case management services for workers' compensation and disability claims, including field-based medical case management (nurse case managers attending appointments and coordinating care/return-to-work), vocational case management (assessments, transferable skills analysis, job analysis, labor market surveys, placement), short-term telephonic case management (typically 30-90 days), and specialized evaluations (long-term disability, earning capacity, file consultations, IME coordination, peer review). The firm also delivers CE courses for licensed adjusters and serves insurance carriers, self-insured employers, TPAs, attorneys, and government entities.

Product overview

Carolina Case Management & Rehabilitation Services, Inc. offers a portfolio of case management services for workers' compensation and disability claims. The core offerings include Medical Case Management (field-based nurse case managers attending appointments and coordinating care), Vocational Case Management (return-to-work assessments, job analysis, and placement services), Telephonic Case Management (short-term phone-based intervention typically lasting 30-90 days), and Specialized Services (customized evaluations for long-term disability, personal injury, and family law matters). Additional offerings include CE Courses for licensed adjusters seeking continuing education credits and a Workers' Compensation Administration resource providing links to state agencies. The company operates from Raleigh, NC and serves clients in North Carolina, South Carolina, Virginia, Georgia, and nationally.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Case Management
• Vocational Case Management
• Telephonic Case Management
• Specialized Services
• CE Courses

Named customers5 records

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

Feature1 record

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Helmsman Management Services (Liberty Mutual): Managed care arm of Liberty Mutual providing workers' comp case management and claims services. Competes with CCM primarily as a carrier-affiliated provider but also serves external customers at national scale.
• Mitchell International: Provider of workers' compensation claims management technology, medical management, and case management services to insurers and TPAs. Overlaps with CCM in case management delivery and competes for carrier preferred-vendor slots.
• Optum Workers' Comp (UnitedHealth Group): National managed care platform providing workers' compensation case management, utilization review, and pharmacy services. Competes with CCM for large national carrier and employer contracts with technology-enabled delivery.
• Sedgwick Claims Management Services: Global claims management and managed care provider serving workers' compensation, disability, and property/casualty claims for large employers and carriers. Overlaps with CCM in WC case management but at vastly greater scale and with a much broader service portfolio.
• Concentra (selectCare): National occupational medicine and workers' compensation managed care provider offering case management alongside clinic services. Overlaps with CCM in WC case management while adding physical clinical delivery and employer clinic services.

Direct peers

• CorVel Corporation: Public company providing workers' compensation managed care, case management, and claims administration services nationally. Competes directly with CCM for carrier and employer WC case management mandates and is one of the largest scaled independents in the space.
• Broadspire (a Crawford & Company business): Provides workers' compensation case management, medical management, and return-to-work services to carriers and employers across the U.S. Direct competitor in WC nurse case management with national reach and parent backing from Crawford.
• Genex Services: One of the largest U.S. workers' compensation case management and managed care companies, providing medical case management, utilization review, and return-to-work services to insurers, employers, and TPAs nationwide. Direct head-to-head competitor to CCM in WC case management.
• Reed Group (a Guardian company): Provides workers' compensation and disability absence management including medical and vocational case management. Direct peer to CCM in the WC/DM case management services space, particularly on the disability overlap.

Regional players

• ESIS (Chubb): Workers' compensation and claims management services offered as part of Chubb's risk management portfolio. Competes with CCM for case management mandates from larger, often multi-state employers and carriers.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/carolina-case-management

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Carolina Case Management