New York Licensed Medical Case Manager

Job Summary

To provide comprehensive telephonic case management, the full-time New York Licensed Medical Case Manager will engage with injured employees, healthcare providers, and employers to ensure appropriate medical care and facilitate return-to-work strategies, working remotely with a preference for hybrid office collaboration.

Key responsibilities

• Utilizes clinical skills to assess and coordinate treatment plans, ensuring medically necessary care delivery
• Performs utilization review activities and maintains accurate documentation in the case management system
• Collaborates with claims adjusters and other stakeholders to develop medical resolution strategies and support injured employees' recovery

Required qualifications

• Active unrestricted New York RN license; New Jersey Compact license preferred
• Bachelor's degree in nursing (BSN) or equivalent work experience preferred
• Five years of related experience, including two years in clinical care or case management
• Certification in case management or related specialty highly preferred
• Fluency in Spanish and English preferred