California RN Telephonic Nurse Case Manager

Job Summary

Seeking a California RN Telephonic Nurse Case Manager to work full-time in a fully remote capacity, responsible for managing medical claims, coordinating care for injured employees, and facilitating communication among stakeholders to promote timely return-to-work outcomes.

Key Responsibilities

• Provide telephonic case management in a Workers' Compensation environment, focusing on medical appropriateness and cost-effective care
• Facilitate communication among employees, employers, insurers, and healthcare providers to ensure quality customer service and care coordination
• Evaluate recovery needs and develop case management care plans, documenting all interactions and outcomes in the system

Required Qualifications

• Current California RN license or ability to obtain California endorsement within 6 months
• Minimum of three years clinical experience in medical-surgical, orthopedic, neurological, or occupational settings
• At least three years of experience in Workers' Compensation case management
• Proven ability to work independently and manage multiple cases effectively
• Familiarity with current trends, standards, and laws related to case management and Workers' Compensation