Manage telephonic case management for workers’ compensation claims, including assessment, care coordination, and ongoing case oversight
Collaborate with injured workers, healthcare providers, employers, claims representatives, and legal partners to support treatment plans and recovery outcomes
Evaluate treatment plans and provide guidance based on clinical knowledge and case management best practices
Facilitate return to work planning and monitor progress toward recovery goals
Maintain frequent telephonic and written communication with all involved parties throughout the life of the claim
Advocate for appropriate and cost effective care while supporting positive health outcomes
Maintain accurate, timely, and compliant documentation of all case activity
Identify barriers to recovery and implement strategies to improve outcomes
Ensure compliance with regulatory requirements, company standards, and HIPAA guidelines
Manage assigned caseload independently, prioritizing work and adjusting plans as needed

Strong understanding of workers’ compensation processes
Case management practices and return to work coordination
Ability to manage a high volume caseload in a structured, metrics driven environment
Strong communication skills with the ability to navigate complex and sensitive conversations
Proficiency with Microsoft Office
Ability to work effectively in a remote setting using multiple systems and screens
Demonstrated ability to work independently while maintaining productivity and quality standards
Strong organizational skills and ability to manage competing priorities
Positive, adaptable mindset with the ability to work effectively in a fast paced environment
Bilingual (Spanish speaking) skills are highly beneficial
Active Registered Nurse (RN) license required
One of the following required: CCM, CDMS, COHN, or CRRN
Associate or bachelor’s degree in nursing or a related clinical field

Workers' Compensation Case Manager

Key skills