Field Nurse Case Manager - Raleigh, NC

Opus Medical; Raleigh (NC); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive pay and bonus program

Health and retirement plans

Flexible scheduling

Nurse referral program

Continuing education support

Job summary

Opus Medical seeks a nurse liaison to coordinate care and communicate medical information among injured workers, insureds, and carriers for timely treatment and successful rehabilitation. This remote, field-based role requires regular local travel up to 2 hours in your region and entails data entry, monthly reporting, and collaboration with physicians and therapists.

The position emphasizes maintaining treatment plans, RTW planning, and ensuring compliant case management while supporting

Qualifications

• Current, unrestricted registered nurse license in each state where field case management is provided.
• Licensed in states where field case management is practiced.
• Completion of a nursing program with ongoing continuing education (CE) requirements.
• Must obtain and maintain at least one nationally recognized certification (e.g., CCM, CRC, CLNC, CRRN) within three years of hire or per state rules.
• Two years of full-time direct case management experience for injured workers, or two years under supervision.

Responsibilities

• Coordinate care and communicate medical information among injured worker, insured, and carrier.
• Retain accountability for the Case Management process per plan.
• Make initial contacts, schedule assessments, and track next physician appointments.
• Maintain ongoing communication with carriers, insured, and providers.
• Record data and billing in CaseAnyplace; submit monthly reports.
• Attend physician appointments to obtain diagnoses, prognosis, and treatment plans.
• Refer to Vocational Counselor for job analyses when approved.
• Coordinate transportation and translation as needed; coordinate IMEs.

Skills

Communication skills

Patient advocacy

Education

Nursing program completion

National certification (CCM/CRC/CLNC/CRRN) within 3 years

Job description

Job Summary

Nurse liaison who coordinates care and communicates pertinent medical information among the Injured Worker, the Insured, and the Carrier to facilitate appropriate treatment, successful rehabilitation, and return to work. Delivers efficient, cost-effective communication for work injuries, MVAs, liability claims, LTD/STD, and other referred services. This is a remote, field-based role that involves regular local travel of up to 2 hours in your region.

Duties & Responsibilities

• Follow all policies/procedures in the Case Management (CM) plan; retain accountability for the CM process.

• Accept referrals as assigned by the Director of Case Management.

• Make initial contacts per CM plan; schedule initial assessment; obtain date of next physician appointment.

• Confirm assignment with referral source; clarify special handling instructions.

• Build professional relationships with clients; treat claimants with dignity.

• After physician appointments, contact Carrier and Insured per protocol; maintain ongoing communication with Injured Worker, Insured, and Carrier.

• Record data and billing in CaseAnyplace; submit timely monthly reports (Preliminary, Initial, Progress, Closing).

• Attend physician appointments; obtain diagnosis, prognosis, treatment plan, rehab length, estimated RTW (modified/regular duty), and MMI/Full Recovery as appropriate.

• Refer to Vocational Counselor for job analyses (modified/regular duty) when appropriate and approved by Carrier.

• Recommend IME physicians; coordinate and attend IMEs.

• Coordinate transportation as needed.

• Provide translation as needed (for bilingual nurses).

• Monitor treatment plan; attend therapy sessions when appropriate; maintain contact with therapists for updates.

• Request transfer of files to Vocational Counselor when appropriate (LMS, Voc Rehab).

• Assist Carrier/Insured with RTW planning (modified or regular duty).

• Provide information to Defense Attorneys as appropriate.

• Promote teamwork with all staff members.

• Maximize accurate, appropriate billable hours per monthly target (8 hrs/day).

• Maintain licensure/certifications; complete required annual training on time.

• Perform additional professional duties as assigned.

• Retain responsibility for tasks delegated to non-clinical staff.

Qualifications

• Registered Nurse: Current, unrestricted state license; licensed in each state where field case management is provided; able to perform independent assessments within scope.

• Discipline Eligibility: Practices in a U.S. state/territory allowing independent assessment within scope of practice.

• Education: Completion of a nursing program and ongoing CE as required.

• Certification: Must obtain and maintain at least one nationally recognized certification (e.g., CCM, CRC, CLNC, CRRN, etc.) within three (3) years of hire or within the state-required timeframe for practice, whichever is less.

• Experience: Two years FTE direct case management for injured workers or two years under supervision preferred.

Benefits

• Competitive pay and bonus program

• Health, dental, vision, and retirement plans

• Flexible scheduling

• Nurse referral program

• Continuing education support