Telephonic Nurse Case Manager (Insurance)

TL;DR

Telephonic Nurse Case Manager (Insurance): Managing medical aspects of Workers’ Compensation claims to ensure high-quality and cost-effective care with an accent on clinical assessment and treatment coordination. Focus on identifying barriers to recovery, developing individualized care plans, and promoting return-to-work outcomes.

Location: Fully remote within the United States

Salary: $78,000 - $83,000 / year

Company

A specialist professional services and technology firm supporting the insurance and regulated sectors globally.

What you will do

• Provide telephonic case management for Workers’ Compensation cases.
• Assess medical treatment plans to optimize recovery and cost efficiency.
• Develop and implement individualized care plans and conduct ongoing clinical assessments.
• Coordinate communication between injured workers, employers, providers, and insurers.
• Monitor provider performance and ensure compliance with state and national treatment guidelines.
• Document return-to-work capability and maintain accurate records in the case management system.

Requirements

• Active, unrestricted RN license.
• Minimum 3 years of clinical experience in medical-surgical, orthopedic, neurological, ICCU, industrial, ER, or occupational health.
• Must be based in the United States.
• Experience in telephonic case management and applying evidence-based disability duration guidelines.
• Proficiency in claims/case management software and computer systems.

Nice to have

• Workers’ Compensation case management experience.
• Prior experience training or mentoring staff.

Culture & Benefits

• Comprehensive medical, dental, and vision plans.
• 401(k) plan with employer matching.
• Discretionary Time Off (DTO) for exempt employees and PTO for non-exempt employees.
• Paid holidays and life insurance.
• Short-term and long-term disability coverage.