Telephonic Nurse Case Manager (Remote)

Location: Home United States; fully remote

Salary: $78,000–$83,000 per year

Company

hirify.global is a professional services and technology firm supporting insurance and other highly regulated businesses with risk management, claims, transformation, and operational solutions.

What you will do

• Manage telephonic Workers’ Compensation cases and make independent decisions on medical claims.
• Assess recovery needs, develop and update care plans, and coordinate treatment across injured employees, employers, insurers, providers, and representatives.
• Evaluate treatment plans, medical records, bills, disability status, and utilization against applicable clinical and state-mandated guidelines.
• Identify barriers to recovery, arrange utilization review activities, develop alternative treatment plans, and support timely return-to-work outcomes.
• Monitor provider licensure, vendor performance, quality of care, patient outcomes, and case documentation.
• Protect confidential medical information and maintain compliance with legal, ethical, accreditation, and regulatory standards.

Requirements

• Registered Nurse with at least three years of clinical experience in a relevant area such as medical-surgical, orthopedic, neurological, industrial, or occupational care.
• At least one year of Florida Workers’ Compensation case-management experience is mandatory.
• Current state nursing licensure and knowledge of clinical standards, trends, and law changes.
• Case-management experience, strong communication and customer-service skills, self-direction, and the ability to work independently.
• Ability to use computers and claims or business software effectively.

Nice to have

• Fluent English and Spanish.
• Experience training claims staff or providing leadership to lower-graded staff.

Culture & Benefits

• Fully remote work arrangement for employees based in the United States.
• Medical, dental, and vision insurance plans.
• 401(k) plan with employer matching.
• Paid time off, paid holidays, and applicable paid sick, family, and parental leave.
• Life insurance and short- and long-term disability coverage.
• Inclusive workplace focused on diversity, professional development, innovation, and client service.