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 to injured workers.

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

• Partner with patients, families, physicians, healthcare providers, employers, referral sources, team members, attorneys, and other key stakeholders.

• Discuss current and alternative treatment options with physicians utilizing medical and nursing expertise.

• Assess, plan, implement, and evaluate patient progress effectively.

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

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

• Attend conferences for discharge planning at hospitals and long-term care facilities.

• Conduct home visits for initial evaluations.

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

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

• Engage in significant local travel and occasional overnight trips.

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

• Perform additional responsibilities as needed.

⛳️ Requirements

• Must be a registered nurse with current RN Licensure in the state of employment.

• Graduate from an accredited nursing school.

• Ideal candidates will have experience as an RN Medical Case Manager.

• A clinical background in orthopedics, neurology, or rehabilitation is preferred.

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

• A valid driver’s license and reliable transportation are essential.

• Willingness to travel to assigned locations is required, including local travel up to approximately 60% of the work week/month.

• Must be available to work Monday–Friday during standard business hours.

• Excellent communication and multitasking abilities in a high-volume, fast-paced, team-oriented environment.

• Strong interpersonal, time management, and organizational skills.

• Proficiency in computer skills and technical aptitude, including Microsoft Office and Excel spreadsheets.

• Ability to work both independently and collaboratively within a team setting.

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

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

• Overnight travel may be necessary.

🏝️ Benefits

• Comprehensive benefits package that includes Medical (HDHP) with Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, as well as Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

• Bonus eligibility for Medical Case Managers.

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

• Opportunities for career advancement.

• A Great Place to Work® company culture.

• An Equal Opportunity Employer and a drug-free workplace.