Telephonic Nurse Case Manager (Remote)
Core
Manage and independently decide on medical claims for injured workers to promote timely return to work while ensuring cost-effective, high-quality care.
Role type
Registered Nurse (RN) Workers' Compensation Case Manager
Builds
Medical treatment plans and recovery strategies for injured employees
Domain
Insurance / Workers' Compensation / Healthcare Administration
Required skills
Clinical assessment, medical record review, treatment plan coordination, physician communication, functional capacity evaluation, evidence-based guideline adherence
Preferred skills
Experience with modified duty and return-to-work programs
Technologies
Electronic health records (EHR), claims management software
Responsibilities
Coordinate and monitor medical treatment for injured workers; Review medical records and diagnostic reports; Provide clinical recommendations on treatment and recovery; Communicate with treating physicians; Partner with claims adjusters on claim evaluation; Evaluate functional capacity and work restrictions; Maintain detailed case documentation
Seniority
Mid-level, hands-on IC