California RN Case Manager - Workers' Comp Care Advocate

AvonRisk LLC; United States; Remote; USD 70,000 - 110,000; Full time

Job summary

AvonRisk LLC seeks a Medical RN Case Manager to ensure maximum medical and disability improvement through proactive care coordination. You will communicate with physicians, injured workers, employers, and claims teams to obtain optimal outcomes while acting as the patient advocate and ensuring authority and direction from the claims adjuster.

The role emphasizes early intervention, cost-effective treatment coordination, and adherence to state guidelines with strong teamwork and professional

Qualifications

• Active California RN license.
• Minimum 1 year clinical experience; workers’ compensation or managed care experience recommended.
• Familiarity with California Workers’ Compensation and utilization review processes.

Responsibilities

• Triage all claims within 24 hours of assignment.
• Make initial contact with employees, employers, and PCP within 72 hours.
• Initiate disability management to identify lost time and coordinate return to work.
• Coordinate medical care and ensure timely, appropriate treatment.
• Review treatment plans using evidence-based guidelines and local rules.
• Summarize medical records and prepare questions for complex cases.

Skills

RN licensure

Utilization review

Care coordination

Documentation

Interdisciplinary collaboration

Education

California RN license

1 year clinical experience

Job description

AvonRisk LLC seeks a Medical RN Case Manager to ensure maximum medical and disability improvement through proactive care coordination. You will communicate with physicians, injured workers, employers, and claims teams to obtain optimal outcomes while acting as the patient advocate and ensuring authority and direction from the claims adjuster.

The role emphasizes early intervention, cost-effective treatment coordination, and adherence to state guidelines with strong teamwork and professional