Medical Case Manager

Crawford & Company; Akron (OH); Remote; USD 60,000 - 90,000; Full time

Job summary

Join a forward-thinking company as a Medical Case Manager, where you can enjoy a work-from-home environment while contributing to meaningful healthcare solutions. This role emphasizes a great work-life balance and offers opportunities for professional growth with benefits like free CEUs and a quarterly bonus program. Your clinical expertise will be pivotal in facilitating return-to-work solutions, ensuring excellent communication with all stakeholders, and maintaining high standards in case management. If you're passionate about making a difference in the lives of others and thrive in a collaborative environment, this position is perfect for you.

Benefits

Great Work Life Balance

Quarterly Bonus Program

Free CEUs for licenses and certificates

License and national certification reimbursement

Qualifications

• 1-3 years of diverse clinical experience required.
• Active RN license in good standing is mandatory.

Responsibilities

• Review case records and analyze data for effective case management.
• Maintain communication with claims adjusters and healthcare providers.

Skills

Communication Skills

Analytical Skills

Organizational Skills

Customer Service Skills

Basic Computer Skills

Education

RN Degree

BSN Preferred

Tools

Microsoft Office

Lotus Notes

Job description

Job Title: Medical Case Manager (Work from Home, Akron, OH Region)

Benefits:

• Great Work Life Balance
• Quarterly Bonus Program
• Free CEUs for licenses and certificates
• License and national certification reimbursement

This is a work-from-home position requiring local travel within the Akron, OH region, including cities such as Akron, Youngstown, Cleveland, Canton, or Mansfield.

Qualifications:

• RN degree required; BSN preferred
• 1-3 years of diverse clinical experience
• Active RN license in good standing
• Preferred: Certification from URAC-approved list (e.g., CCM, CRC, COHN, CRRC)
• Prior Workers' Compensation Case Management experience preferred
• Knowledge of case management practices and workers compensation products
• Excellent communication, analytical, organizational, and customer service skills
• Basic computer skills including Microsoft Office and Lotus Notes
• Ability to establish collaborative relationships with claims adjusters, employers, patients, attorneys, and staff
• Must meet state-specific requirements for medical case management services
• Must maintain a valid driver's license and be willing to travel approximately 70% of the time
• Based on law, may require COVID-19 vaccination

Responsibilities:

1. Review case records, analyze data, and evaluate medical status to facilitate effective case management and return-to-work solutions
2. Provide opinions on case costs, treatment plans, and outcomes, and make recommendations
3. Meet productivity and quality standards with minimal supervision
4. Perform job site evaluations as needed
5. Establish professional relationships to facilitate timely return-to-work
6. Maintain communication with claims adjusters and all involved parties
7. Coordinate with healthcare providers and obtain necessary medical records
8. Utilize clinical expertise to interpret medical data
9. Travel to homes, healthcare providers, and job sites as required
10. Meet monthly production and quality assurance requirements
11. Review cases with supervisors and uphold company standards and conduct
12. Provide excellent customer service and problem-solving independently