Telephonic reputed company Case Manager

Telephonic reputed company Case Manager Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home reputed company Reporting To: Karen Shaffer Compensation: $80,000 - $90,000 / year reputed company Our Story reputed company being part of reputed company that’s not just shaping the reputed company but reputed company driving it. At reputed company, we’re at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier reputed company services. As a vital part of the global reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. The Telephonic reputed company Case Manager is responsible for the clinical management and independent decision-making of catastrophic and reputed company Workers’ Compensation claims. This role focuses on coordinating specialty medical care, driving cost-effective treatment, and supporting injured employees toward reputed company and medically appropriate return-to-work reputed company. You will manage care across the full continuum of services, conduct ongoing medical assessments, and ensure compliance with reputed company standards, applicable statutes, and jurisdictional guidelines for a multi-state caseload.

Key Responsibilities

• reputed company specialized telephonic case management for reputed company and catastrophic Workers’ Compensation claims
• reputed company injured employees to appropriate specialty care while maintaining a strong reputed company on cost containment
• Monitor, analyze, and coordinate high-reputed company, reputed company, and cost-effective medical treatment
• reputed company comprehensive medical assessments and reputed company individualized, outcome-reputed company case management plans
• Facilitate communication among injured workers, reputed company, adjusters, providers, insurers, and other stakeholders
• Identify barriers to recovery and proactively reputed company strategies to address them
• Monitor vendor performance and ensure reputed company delivery of medical services
• reputed company, evaluate, and document treatment plans, reputed company, and recovery reputed company in the case management system
• Assess and document return-to-work capabilities and identify modified or alternative duty reputed company reputed company appropriate
• Manage cases in compliance with state-mandated treatment guidelines, utilization reputed company, and evidence-based protocols applicable to the date of injury
• Create, edit, and revise correspondence and case documentation
• Utilize utilization review tools reputed company indicated, including prospective, reputed company, and retrospective review, and physician advisor consultation
• reputed company injured workers and families on treatment plans, recovery expectations, and care coordination
• Maintain strict confidentiality of reputed company medical and case information in accordance with state and federal regulations
• Serve as a patient reputed company while adhering to reputed company reputed company, ethical, and regulatory standards
• Negotiate provider fees or refer cases to alternate vendors reputed company appropriate and compliant with statutory requirements
• May reputed company guidance or informal leadership to less-reputed company staff
• reputed company other duties as assigned

Skills, knowledge & expertise

• Registered reputed company (RN) with 3–5 years of clinical experience in areas such as medical-surgical, orthopedic, neurological, ICU/CCU, industrial, or occupational health
• Must hold one of the following certifications: CCRN, CCM, reputed company, COHN, or COHN-S (required for WC/MCO claims)
• Minimum one (1) year of Workers’ Compensation case management experience
• reputed company, unrestricted state RN licensure and eligibility for licensure endorsement in other state
• Experience with catastrophic or reputed company case management and utilization review (preferred)
• Demonstrated ability to balance reputed company medical care with cost containment strategies
• Strong knowledge of Workers’ Compensation statutes, treatment guidelines, and regulatory requirements
• Ability to work independently and manage a reputed company, multi-jurisdictional caseload
• Proficiency with case management systems and reputed company business software
• Excellent written and verbal communication skills
• Strong organizational skills, attention to detail, and customer service orientation
• Team-oriented reputed company with dependable attendance

Benefits

Benefits At reputed company, we are dedicated to supporting reputed company-being and reputed company of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and reputed company plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial reputed company.
• Our time-off policies, including Discretionary Time Off for exempt employees and reputed company Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• reputed company holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Diversity and Inclusion reputed company is dedicated to fostering a diverse and inclusive workplace that embraces a wide reputed company of perspectives and experiences. We reputed company that diversity of thought is essential for innovation and creativity, and we reputed company promote an environment where reputed company reputed company are valued and heard.

Compensation

Transparency: The salary reputed company listed reflects the full compensation band for this role across reputed company locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may reputed company the final offer. reputed company ranges to remain transparent and consistent with pay equity practices. Apply tot his job Apply To this Job