Florida Licensed Medical Case Manager

Job Summary

Providing comprehensive telephonic case management, the full-time Florida Licensed Medical Case Manager will engage with injured employees, healthcare providers, and employers to facilitate a medically appropriate return to work, while working remotely with a preference for a hybrid arrangement.

Key responsibilities

• Utilizes clinical skills to assess the medical necessity and appropriateness of care for injured employees
• Performs utilization review activities and coordinates treatment programs to maximize quality and cost-effectiveness
• Collaborates with claims adjusters and other stakeholders to develop and implement effective medical resolution strategies

Required qualifications

• Active unrestricted RN license in a state or territory of the United States
• Bachelor's degree in nursing (BSN) or equivalent work experience preferred
• 3+ years of related experience, including 2+ years in direct clinical care or case management
• Certification in case management, pharmacy, rehabilitation nursing, or a related specialty is highly preferred
• Fluency in Spanish and English is preferred