Encompass Workers' Comp Solutions

What Encompass Workers' Comp Solutions does

Encompass Health Solutions, Inc., operating as Encompass Workers' Comp Solutions, is a privately held California corporation that provides specialized workers' compensation injury management services. The company delivers telephonic nurse case management statewide across California and field-based nurse case management concentrated in Southern California, where case managers engage in-person with injured employees and treating providers. The service portfolio also includes URAC-accredited California Utilization Review under a DWC-approved UR plan, an Employee Advocate Program offering neutral navigation support for injured workers, and customized injury management programs that act as clinical gatekeepers for treatment, return-to-work, ancillary services, and Medicare Set-Aside coordination.

The company's technology footprint is service-delivery oriented rather than software-platform oriented. There is no public evidence of APIs, SDKs, mobile applications, integrations, or proprietary software systems. Core operational technology consists of clinical workflows executed by licensed and credentialed staff: an RN/CCM-certified Manager of Case Management, an MD Medical Director, a CCMP-certified CEO/President, and a SHRM-CP-certified CAO/VP. Customer engagement is routed through a toll-free number ((888) 822-7211), direct email ([email protected]), and PDF-based online referral forms for Nurse Case Management and Utilization Review.

Encompass generates revenue through professional services engagements — primarily on a per-case or contractual basis — with California employers, insurance carriers, and third-party claims administrators (TPAs). Pricing is not publicly disclosed, and the company does not appear to use resellers, channel partners, or intermediaries. The go-to-market motion is sales-led and referral-driven, relying on URAC accreditation, California-specific domain expertise, and direct business development. The company has no disclosed parent, subsidiaries, funding rounds, M&A activity, partnerships, patents, or trademarks, and reports no headcount in the available materials.

Name

Encompass Workers' Comp Solutions

Legal name

Encompass Health Solutions, Inc.

Website

https://encompasswc.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

11–50 employees

Short description

Encompass Workers' Comp Solutions is a California-based, privately held provider of URAC-accredited workers' compensation case management and utilization review services, serving California employers, insurance carriers, and TPAs via telephonic and field-based nurse case management.

Ownership category

akta.pro rank

Product category

Workers' Compensation Case Management

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Vocational Rehabilitation Services (6243)

SIC

Services-Facilities Support Management Services (8744)

akta.pro primary industry

Workers’ Compensation & Occupational Health TPA (HLAEALAL)

akta.pro secondary industries

Managed Workers’ Compensation (Loss Control, Claims & Return-to-Work Programs) (FSAJAEAH), Occupational Health & Worksite Health Virtual Care (fit-for-duty, RTW) (HLALADAM)

Keywords

• Workers compensation case management
• Nurse case management
• Utilization review services
• California workers compensation
• Injury management programs

Headquarters

HQ city

Folsom

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 services revenue from providing telephonic and field nurse case management services to workers' compensation claims. Services are typically contracted on a per-case or per-claim basis with insurance carriers, employers, and claims administrators.
2. Utilization Review Services: URAC-accredited utilization review services for California workers' compensation cases, providing clinical review of treatment requests to ensure appropriateness and compliance with California regulations.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels3 records

Core offering

Encompass Workers' Comp Solutions provides workers' compensation injury management services in California, including telephonic and field nurse case management, URAC-accredited utilization review, and employee advocacy programs. The company coordinates medical treatment, facilitates return-to-work, and manages utilization review for employers, insurance carriers, and third-party administrators handling California workers' compensation claims.

Product overview

Encompass Workers' Comp Solutions is a workers' compensation injury management service provider offering a unified suite of case management and utilization review services. The portfolio consists of six integrated services: Telephonic Nurse Case Management (statewide), Field Nurse Case Management (Southern California), California Utilization Review (URAC-accredited), Employee Advocate Program, general Nurse Case Management, and Customized Injury Management Programs. These services work together to guide injured employees through medical treatment, coordinate care, manage utilization review, and facilitate safe return-to-work outcomes.

Differentiator

Problem solved

Functional benefit

Products and services

• Telephonic Nurse Case Management Case management services provided remotely via telephone for California workers' compensation claims. Focused on obtaining excellent medical treatment, decreasing fragmented treatment, and coordinating a safe and timely return to work for injured employees throughout California.
• Field Nurse Case Management In-person case management services in Southern California where case managers interact face-to-face with the medical community responsible for treatment and the injured employee. Functions as a clinical gatekeeper to coordinate medical treatment, return-to-work, ancillary services, causation statements, and medication clarification for Medicare Set-Asides.
• California Utilization Review URAC-accredited best practice Utilization Review services for California workers' compensation claims, including a filed UR plan with the California Department of Workers' Compensation (DWC). Provides clinical review of treatment requests to ensure medical appropriateness and compliance with California regulations.
• Employee Advocate Program Provides injured employees with a neutral resource to navigate the complexities of workers' compensation. Addresses concerns about treatment, time loss from work, and impact on employment and home environment to reduce frustration that can lead to litigation.

Segments2 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Direct peers

• Enlyte: Parent organization of Genex Services and other workers' compensation managed care brands, providing utilization review, case management, and claims solutions to carriers and employers nationwide — direct multi-brand competitor.
• MCMC: Independent utilization review and medical peer review organization serving workers' compensation payers — directly comparable to Encompass's URAC-accredited utilization review service line.
• MedRisk: Managed care organization providing physical medicine and workers' compensation case management services to insurers and employers — overlapping clinical case management and utilization review functionality.
• Genex Services: National workers' compensation case management and managed care provider (now part of Enlyte) offering telephonic and field nurse case management, utilization review, and return-to-work services — directly competing in the same clinical service categories.
• CorVel Corporation: Public managed care company providing workers' compensation case management, utilization review, and return-to-work services nationally — a closely comparable service model with overlapping employer and carrier customer base.
• ESIS: Chubb's in-house third-party claims administrator providing workers' compensation claims management, medical case management, and utilization review — comparable service portfolio serving carriers and employers.
• Sedgwick: Largest U.S. workers' compensation claims management and utilization review TPA, serving carriers, employers, and TPAs with multi-state case management and clinical services — directly comparable to Encompass's core offering at much larger scale.
• Helmsman Management Services: Workers' compensation managed care and claims administration services provider offering case management and return-to-work coordination for self-insured employers and carriers — closely comparable service model.
• Align Managed Care: Specialized managed care organization offering workers' compensation case management, utilization review, and bill review services to payers and employers — directly comparable niche managed care competitor.

Broad incumbents

• The Hartford (Workers' Comp): Major national insurance carrier with significant workers' compensation underwriting and managed care service capabilities — a broader incumbent that competes for carrier and employer accounts while offering a wider product portfolio.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat3 records

Key risks5 records

Key highlights5 records

Customer concentration

• LinkedInlinkedin.com/company/encompasswc

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 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 Encompass Workers' Comp Solutions