Workers Compensation Telephonic Nurse Case Manager

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

📋 Description

• Evaluate, plan, coordinate, monitor, assess, and implement options and services to ensure timely medical care and effective return-to-work outcomes for injured workers.

• Oversee and execute medical case management to promote case closure.

• Maintain timely and comprehensive communication with employers, adjusters, and injured workers.

• Evaluate the appropriate use of medical treatments and services by liaising with physicians and specialists to guarantee cost-effective, quality care.

• Review and analyze medical records, assessing data to ensure proper case management while providing recommendations to facilitate case progress and closure.

• Manage assigned caseloads, which may differ in numbers, territory, and/or state jurisdiction.

• Coordinate home services, durable medical equipment, independent medical examinations (IMEs), admissions, discharges, and vocational services when applicable, assessing cost-effectiveness and quality.

• Document activities and case progress using suitable methods and tools in line with quality-improvement best practices.

• Review job analyses and descriptions with providers and coordinate disability case management and return-to-work initiatives with employers.

• Engage in special projects as designated by case management leadership.

• Occasionally participate in onsite meetings and professional programs.

• Promote a collaborative team environment.

• Maintain and update evidence-based medical guidelines regarding injured-worker treatment plans and work status.

⛳️ Requirements

• At least 2 years of experience in workers' compensation insurance and medical case management is preferred.

• Ability to work during Pacific Standard Time business hours.

• A California RN license is highly preferred.

• A minimum of 4 years of medical/surgical clinical experience is required.

• Strong communication skills, professionalism, flexibility, and adaptability are essential.

• Working knowledge of medical and vocational resources available within the Workers’ Compensation industry.

• Evidence of self-motivation and the capability to perform case management duties independently.

• Proficient in computer and technology skills.

• Fluency in both Spanish and English, both orally and in writing, is a plus.

• Graduate of an accredited nursing program and possess a current RN license.

• RN compact license is preferred.

• Certified Case Manager (CCM) is preferred.

• Bachelor of Nursing is preferred.

• Domestic U.S. travel may be required (up to 10% of the time).

• Must obtain a case management professional certification (CCM) within 2 years of the hire date.

• Acquire and maintain nursing licensure for all jurisdictions as business needs dictate.

• Obtain and maintain relevant state certifications and/or licenses in the state where job duties are performed.

• Complete Continuing Education Units to retain certifications and licenses.

🏝️ Benefits

• Health

• Dental

• Vision

• Life

• Disability

• Wellness

• Paid Time Off

• 401(k)

• Profit-Sharing plans

• Competitive compensation plan

• Comprehensive benefits package