Nurse Medical Case Manager - Workers Compensation - Remote

Overview

The Nurse Medical Case Manager will provide telephonic medical case management with a focus on early intervention and coordination of quality medical care for workers compensation claims.

In Short

• Provide telephonic medical case management for workers compensation claims.
• Coordinate medical care and develop return to work plans.
• Evaluate treatment requests based on jurisdictional guidelines.
• Engage with medical providers and injured parties.
• Utilize internal systems for claim management.
• Participate in telephonic and onsite file reviews.
• Maintain insurance licenses and certifications.
• Work collaboratively with claim professionals.
• Document all activities accurately.
• Assist injured employees in achieving optimal recovery.

Requirements

• Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse required.
• Experience in disability case management preferred.
• Familiarity with URAC standards.
• Strong communication and negotiation skills.
• Basic knowledge of insurance contracts and legal regulations.
• Analytical thinking and problem-solving abilities.
• Ability to work within jurisdictional parameters.
• Customer service orientation.
• Teamwork and collaboration skills.
• Certifications like CCM or CDMS preferred.

Benefits

• Health insurance from day one of employment.
• 401(k) matching contributions.
• Pension plan fully funded by the company.
• Minimum of 20 days paid time off annually.
• Access to wellness programs and mental health resources.
• Encouragement for community involvement and volunteering.
• Performance-based cash incentive awards.
• Diversity and inclusion initiatives.
• Comprehensive benefits program.
• Employee recognition and development opportunities.