Triage Telephonic Nurse Case Manager
MDD Forensic Accountants
full-time
Posted on:
Location Type: Remote
Location: Remote • Alabama • 🇺🇸 United States
Visit company websiteSalary
💰 $66,000 - $67,000 per year
Job Level
Mid-LevelSenior
About the role
- Provide triage case management at the initial report of a Workers’ Compensation claim, focusing on medical appropriateness of care and cost efficiency.
- Utilize strong clinical assessment skills to gather all pertinent medical and injury-related information from the injured employee.
- Conduct comprehensive initial evaluations, integrating details from the employee, employer, and provider into an actionable care plan.
- Identify causal relationship issues and notify appropriate parties.
- Facilitate communication among all stakeholders—employee, employer, insurer, providers, and when authorized, rehabilitation consultants.
- Participate in the 24/7/365 intake call center, ensuring timely coordination of care for injured workers.
- Develop and document an initial case management plan and return-to-work strategy.
- Evaluate treatment adherence to state-mandated and evidence-based guidelines.
- Document all assessments, communications, and clinical updates in the electronic claims management system.
- Identify and document barriers to recovery for future case planning.
- Serve as a patient advocate, maintaining compliance with all legal, ethical, and confidentiality standards.
- Monitor clinical outcomes, quality of care, and patient satisfaction.
- May assist in training claims staff on recognizing medical case management opportunities.
- May provide mentorship or guidance to less experienced team members.
Requirements
- Strong knowledge of medical case management practices, preferably in a Workers’ Compensation setting.
- Excellent communication and interpersonal skills.
- Ability to work independently in a fast-paced, collaborative environment.
- Proficient in computer systems and claims or case management software.
- Demonstrated commitment to patient-centered care and ethical case management practices
- Maintains up-to-date knowledge of current clinical trends, standards, and regulations.
- Registered Nurse (RN) with active state licensure (Florida preferred).
- Minimum of three years of clinical experience in medical-surgical, orthopedic, neurological, industrial, or occupational health settings.
- At least one year of Workers’ Compensation case management experience preferred.
- Strong organizational skills and attention to detail.
Benefits
- Medical, dental, and vision plans to ensure your health and that of your family.
- A 401k plan with employer matching to help you build a secure financial future.
- Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
- Paid holidays.
- Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical case managementclinical assessmentinitial evaluationscase management plantreatment adherenceelectronic claims managementpatient advocacymonitoring clinical outcomesquality of carepatient satisfaction
Soft skills
communication skillsinterpersonal skillsindependent workcollaborative environmentpatient-centered careethical practicesorganizational skillsattention to detailmentorshiptraining
Certifications
Registered Nurse (RN)active state licensure