Georgia Licensed Medical Case Manager

Job Summary

Providing comprehensive telephonic case management, the full-time Georgia Licensed Medical Case Manager will engage with injured employees, healthcare providers, and employers to facilitate appropriate medical care and return-to-work strategies in a remote setting.

Key responsibilities

• Utilizes clinical skills to assess and coordinate treatment plans, ensuring medically necessary care is delivered effectively
• Performs utilization review activities and maintains accurate documentation of case management activities
• Collaborates with claims adjusters and other stakeholders to develop medical resolution strategies and address job modifications based on medical assessments

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/utilization management
• Certification in case management, pharmacy, rehabilitation nursing, or a related specialty is highly preferred
• Fluency in Spanish and English is preferred