Medical Case Manager

Crawford & Company; Charlotte (NC); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated RN for a remote Case Management role, covering the Raleigh and Greensboro territories. This position offers a great work-life balance and the opportunity to make a significant impact on injured workers' lives. You will be responsible for managing cases, evaluating medical statuses, and coordinating with various stakeholders to facilitate smooth returns to work. With a focus on quality and productivity, this role promises professional growth and the chance to work independently while maintaining strong communication with all parties involved. Enjoy perks like a quarterly bonus program and reimbursement for certifications.

Benefits

Great Work Life Balance

Quarterly Bonus Program

Free CEUs for licenses and certificates

License and national certification reimbursement

Qualifications

• Active RN license in good standing required.
• 1-3 years clinical experience preferred.

Responsibilities

• Provide effective case management services in accordance with URAC and CMSA standards.
• Coordinate with injured workers and healthcare providers to facilitate Return to Work.

Skills

Case Management

Communication Skills

Analytical Skills

Organizational Skills

Education

RN Degree

Associate's Degree in Nursing

BSN

National Certification (CCM, CRC, COHN, CRRC)

Job description

* 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 travel covering both Raleigh and Greensboro territories.

Minimum Requirements

1. RN degree required
2. National Certification such as CCM, CRC, COHN, CRRC preferred
3. Prior Workers Compensation Case Management preferred
4. Associate's degree or relevant coursework/certification in Nursing required; BSN preferred
5. Active RN license in good standing in the home state
6. Minimum of 1-3 years clinical experience
7. Must be compliant with state requirements regarding national certifications
8. Must maintain a valid driver's license and be willing to travel approximately 70% of the time

Key Responsibilities

1. Provide effective case management services in accordance with URAC, CMSA standards, and company guidelines
2. Review case records, evaluate medical status, and identify needs and obstacles for RTW (Return to Work)
3. Coordinate with injured workers, employers, and healthcare providers to facilitate RTW
4. Maintain communication with claims adjusters and other parties involved
5. Perform job site evaluations and facilitate medical reviews and assessments
6. Meet productivity and quality standards
7. Travel to homes, healthcare providers, and job sites as needed
8. Maintain documentation and participate in regular case reviews with supervisors
9. Uphold company code of conduct and demonstrate excellent customer service

Additional qualifications include strong communication, analytical skills, organizational ability, and the capacity to work independently.