RN Telephonic Nurse Case Manager
MDD Forensic Accountants
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $73,000 - $75,000 per year
About the role
- Provide telephonic case management for workers’ compensation claims
- Evaluate medical treatment plans for appropriateness and evidence-based care
- Coordinate communication between injured worker, employer, adjuster, and providers
- Develop and update individualized care plans to support recovery and return-to-work
- Identify barriers to recovery and implement action plans to address them
- Monitor medical progress and functional status throughout treatment
- Educate injured workers regarding treatment plans and recovery expectations
- Facilitate return-to-work discussions with providers and employers
- Ensure compliance with state guidelines, clinical protocols, and client requirements
- Utilize utilization review tools when appropriate (pre-certification, concurrent review, retrospective review)
- Document case activity and medical updates in claims systems accurately and timely
- Maintain confidentiality in accordance with HIPAA and regulatory standards
- Support client relationships through professional communication and service excellence
- Participate in quality assurance activities and training as needed
Requirements
- Active RN license (compact license preferred)
- 3+ years clinical nursing experience (ER, ICU, Med-Surg, Ortho, Neuro, Occupational, or similar)
- 3+ years Workers’ Compensation case management experience
- Ability to independently manage a caseload in a remote environment
- Strong written and verbal communication skills
- Certified Case Manager (CCM) or related certification preferred
- Experience with utilization review processes
- Experience working with multiple jurisdictions or state guidelines
- Knowledge of workers’ compensation medical management and return-to-work principles
- Understanding of treatment guidelines and disability duration concepts
- Strong critical thinking and clinical assessment abilities
- Ability to build rapport with injured workers and providers
- Effective time management and organization skills
- Proficiency in case management and claims software systems
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 & Tools
clinical nursingworkers' compensation case managementutilization reviewmedical treatment evaluationindividualized care planscase documentationtreatment guidelinesdisability duration conceptscritical thinkingclinical assessment
Soft Skills
communicationtime managementorganizationrapport buildingindependent caseload managementservice excellenceeducational skillsproblem-solvingquality assurance participationprofessional communication
Certifications
RN licenseCertified Case Manager (CCM)