Medical Case Manager I

This is a fully remote position, open to applicants in California.

📋 Description

• Deliver both in-person and telephonic Medical Case Management services.

• Collaborate closely with injured workers to support their recovery process.

• Work in conjunction with patients, families, medical professionals, team members, employers, referral sources, attorneys, advisors, and clients.

• Consult with physicians regarding current and alternative treatment strategies, utilizing medical and nursing expertise.

• Assess, plan, execute, and evaluate the progress of patients.

• Review treatment plans for their suitability, medical necessity, and cost-effectiveness.

• Participate in visits to doctors, providers, homes, and occasionally attorneys.

• Engage in discharge planning conferences at hospitals and long-term care facilities.

• Evaluate the appropriateness of care and formulate long-term care strategies.

• Conduct home visits for initial assessments.

• Negotiate the provision of durable medical equipment and nursing services.

• Manage a caseload of workers’ compensation injured workers within a specified jurisdiction.

• Travel locally for up to approximately 60% of the work week/month.

• Adhere to safety regulations and guidelines as outlined in the Injury and Illness Prevention Program.

• Undertake additional responsibilities as necessary.

⛳️ Requirements

• Must be a Registered Nurse (RN).

• Possess effective communication and multitasking abilities in a busy, fast-paced, team-oriented setting.

• Capability to meet with patients, physicians, healthcare providers, attorneys, advisors/clients, and colleagues.

• Background in cost containment, such as utilization review or managed care, is advantageous.

• Strong interpersonal, time management, and organizational skills are essential.

• Proficient in computer skills and possess technical aptitude.

• Ability to use Microsoft Office, including Excel spreadsheets.

• Work effectively both independently and as part of a team.

• Graduate from an accredited nursing school.

• Hold a current RN license in the state of operation.

• Certification as a CCM, CIRS, or other Case Management credential is preferred.

• Valid driver’s license and reliable transportation are required.

• Ability to travel to designated locations.

• Experience as an RN Medical Case Manager is highly desirable.

• Clinical experience in orthopedics, neurology, or rehabilitation is preferred.

🏝️ Benefits

• Comprehensive benefits package available for full-time regular employees.

• Medical insurance (HDHP) including Pharmacy coverage.

• Dental insurance offerings.

• Vision insurance included.

• Long Term Disability coverage.

• Health Savings Account options.

• Flexible Spending Account alternatives.

• Life Insurance policies.

• Accident Insurance available.

• Critical Illness Insurance options.

• Pre-paid Legal Insurance provided.

• Parking and Transit FSA accounts.

• 401K retirement plan.

• ROTH 401K option.

• Paid time off benefits.

• Bonus eligibility for Medical Case Managers.

• Access to state-of-the-art technological devices.

• Opportunities for career advancement.

• Supportive workplace culture.

• Recognized as a Great Place to Work® company.