Telephonic Case Manager

Mitchell; Toronto; Remote; CAD 54,000 - 95,000; Full time

Job summary

A healthcare management company is seeking a Telephonic Case Manager in Toronto, Canada, to provide case management services and support injured clients. This full-time, remote position offers competitive compensation ranging from $54,500 to $95,000. The ideal candidate should have a nursing degree and experience with worker's compensation, advocating for clients, and collaborating with various stakeholders to ensure effective treatment plans.

Benefits

Comprehensive benefits program

24 days of paid vacation/holidays

Employee Assistance and Referral Program

Qualifications

• 2+ years clinical practice preferred.
• Active Registered Nurse (RN) license required.
• Prior Case Management experience preferred.

Responsibilities

• Provides case management services to injured employees on behalf of carriers/employers.
• Communicates and collaborates with the insurance carrier.
• Analyzes clinical information to identify care needs.

Skills

Ability to advocate recommendations effectively

Knowledge of basic computer skills including Excel, Word, and Outlook Email

Excellent organizational skills

Ability to work independently

Education

Associates Degree or Bachelor’s Degree in Nursing or related field

Job description

Company Overview

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry‑leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting‑edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.

Be part of a team that makes a real difference.

Job Description

This is a full‑time, flexible work‑from‑home position and can be located anywhere in Toronto, Canada.

Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, Employee Assistance and Referral Program, and hands‑on workers’ compensation case management training.

Join our compassionate team and help make a positive difference in an injured person’s life. The Telephonic Case Manager provides case management services to clients. Assesses and documents case activities in a timely manner, facilitates timely return to work, reviews medical aspects of claims, recommends diagnostic procedures and testing, and coordinates second opinions. The case manager interacts with insurance providers, treatment providers, and employer and client to ensure the success of the treatment plan. The case manager also evaluates the progress of the treatment and makes necessary adjustments to it.

• Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process.
• Provides case management services to injured employees on behalf of carriers/employers.
• Facilitates communication with third party payers, providers, injured employees and employers to reduce disability costs.
• Provides goals that are customer/client‑oriented, results‑oriented, quality‑oriented and in accordance with province‑specific case management requirements within the workers' compensation insurance industry.
• Provides comprehensive review of available medical records to assess for case management value and identify complex medical conditions.
• Uses clinical experience, knowledge, evidence‑based guidelines, and other resources to proactively evaluate the medical and disability status in order to assist adjuster in appropriately setting reserves.
• Analyzes clinical information to identify care needs and strategize with all parties to create common goals to reach maximum medical improvement and to promote safe return to work for the injured employee. Based on this analysis, develops pro‑active action plans to outline expected barriers and recommend cost‑saving solutions.
• Communicates and collaborates with the insurance carrier to control high medical costs by providing updates on condition changes and treatment expectations.
• Follows specific account instructions regarding timeframes to provide reports to clients and formats.
• Documents savings on case concurrently while the case is open and describes value added to case in closing summary.
• Understands and complies with current industry accepted case management guidelines.
• Stays informed and complied with province/federal legislation as it applies to case management for an assigned geographic region.
• Provides leadership and assistance to co‑workers.
• Reporting billing hours in accordance with case activity and billing practices.
• Stays informed of healthcare industry current practices and trends.

Knowledge: You will be responsible for managing up to 55 cases per month. A clinical background related to trauma, neurological, orthopedic, or occupational health nursing is required. Worker's compensation experience is required.

Job Complexity: Works on problems of diverse scope where analysis of data requires evaluation of identifiable factors. Demonstrates good judgment in selecting methods and techniques for obtaining solutions. Networks with senior internal and external personnel in own area of expertise.

Supervision: You will receive general instructions on new assignments and little instruction on day‑to‑day work.

Qualifications

• Education: Associates Degree or Bachelor’s Degree in Nursing or related field.
• Experience: 2+ years clinical practice preferred. Workers’ compensation‑related experience preferred.
• Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.
• Other qualifications: Prior Case Management experience preferred. Experience in rehabilitation services industry, vocational/occupational/industrial nursing preferred. Background in provincial workers’ compensation law and practices desirable. Excellent interpersonal skills and phone manners. Excellent organizational skills. Ability to set priorities. Computer literacy required.
• Certifications, Licenses, Registrations:
  • Active Registered Nurse (RN) license required. Must be in good standing.
  • URAC‑recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN‑S, RN‑BC, ACM, CMAC, CMC).
• Internet: Must have reliable internet.

Benefits

We’re committed to supporting your ultimate well‑being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Life and AD&D Insurance, Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full‑time or part‑time status. Compensation depends on the applicable Canadian geographic market. The expected base pay for this position ranges from $54,500 - $95,000 annually, and will be based on a number of additional factors including skills, experience, and education.

The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Don’t meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.

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Keywords

• Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers’ Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager