Nurse Case Manager

Medical Case Manager We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future. Nurse Case Manager This fully remote role provides telephonic case management for injured workers. The Nurse Case Manager assesses, plans, and coordinates care to support recovery and timely return to work.

Using clinical expertise, this role develops proactive strategies, collaborates with key stakeholders, and drives cost-effective medical and claim outcomes. Key

Responsibilities

Conduct comprehensive clinical assessments using telephonic interviews, medical records, and data from multiple sources, addressing complex conditions including co-morbidities and biopsychosocial factors Develop and implement individualized case management strategies to support medical stability and timely return to work Identify complex cases requiring additional coordination and collaborate with internal and external stakeholders to evaluate injury, causation, and work capacity Apply clinical guidelines, company policies, and regulatory

Requirements

to ensure compliant and appropriate case management decisions Utilize a holistic approach to focus on medical care and functional recovery, promoting efficient treatment and return-to-work outcomes Partner with supervisors and cross-functional teams to address barriers, resolve issues, and support overall claim performance through meetings and case reviews

Required qualifications

Qualifications

RN with current unrestricted state licensure (CA is preferred) Associate's Degree in Nursing required

Preferred qualifications

Qualifications

Minimum 3 years of clinical experience in one or more of the following: Acute care Orthopedics Rehabilitation Occupational/industrial health Behavioral health Disability Case management CCM, CDMS, CRC, CVE, and/or current CRRN or willingness to pursue Bachelor’s degree in nursing Workers

Compensation

case management experience Key Competencies Proficiency in Microsoft Office and navigating multiple systems Ability to effectively communicate telephonically and in written form. Work requires the ability to perform close inspection of handwritten and computer generated documents as well as a PC monitor.

Ability to synthesize large volumes of medical records & facilitate multi-point care coordination Must meet productivity & quality expectations Ability to independently and effectively organize and prioritize daily work ATS provider: Paylocity.