Multistate Licensed Nurse Case Manager

Job Summary

Providing telephonic nurse case management for workers' compensation claims, the full-time Multistate Licensed Nurse Case Manager will evaluate medical treatment appropriateness, coordinate return-to-work plans, and collaborate with various stakeholders to ensure optimal recovery outcomes.

Key responsibilities

• Manage telephonic case management for new and ongoing workers' compensation claims, ensuring timely evaluations and interventions
• Develop and oversee return-to-work plans in collaboration with injured employees, treating physicians, and HR to facilitate safe reintegration into the workplace
• Monitor medical costs and treatment plans, advocating for appropriate care while identifying potential fraud or compliance issues

Required qualifications

• Active, unrestricted Registered Nurse (RN) license with multistate compact privileges
• Certified Case Manager (CCM) certification required; additional certifications such as COHN or CDMS preferred
• Minimum of 5 years of clinical nursing experience, including 3 years in workers' compensation nurse case management
• Demonstrated experience managing a caseload across multiple jurisdictions and familiarity with evidence-based treatment guidelines
• Bachelor of Science in Nursing (BSN) required; a Master's degree in Nursing or related field preferred