Medical Case Manager

Crawford & Company; Grand Rapids (MI); Remote; USD 60,000 - 90,000; Full time

Job summary

An innovative firm is seeking a dedicated RN for a work-from-home case management role, requiring local travel in the Grand Rapids area. This position offers a great work-life balance and a quarterly bonus program. You will provide essential case management services, ensuring compliance with industry standards while collaborating with healthcare providers and employers. If you're passionate about helping injured workers return to work effectively and enjoy a supportive work environment, this opportunity is perfect for you.

Benefits

Great Work Life Balance

Quarterly Bonus Program

Free CEUs for licenses and certificates

License and national certification reimbursement

Qualifications

• RN degree required with preferred national certification.
• Experience in Workers' Compensation Case Management preferred.

Responsibilities

• Provide effective case management services compliant with standards.
• Analyze data and evaluate medical status for case resolution.

Skills

Case Management

Data Analysis

Communication

Education

RN Degree

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 local travel within the Grand Rapids, MI region for field case management.

Minimum Requirements:

1. RN degree is required.
2. National Certification such as CCM, CRC, COHN, CRRC is preferred.
3. Prior Workers' Compensation Case Management experience is preferred.

Responsibilities:

• Provide effective case management services that are cost-effective and compliant with URAC, CMSA Standards, and Broadspire QA Guidelines.
• Review case records, analyze data, evaluate medical status, and identify needs to facilitate case resolution and RTW.
• Offer opinions on case costs, treatment plans, and outcomes, and make recommendations to meet case management goals.
• Meet administrative and QA standards with minimal supervision.
• Perform job site evaluations as needed.
• Coordinate RTW efforts by establishing relationships with injured workers, physicians, and employers.
• Communicate regularly with claims adjusters and involved parties.
• Obtain and review medical records, facilitate referrals, and interpret medical information.
• Travel approximately 70% of the time to homes, healthcare providers, and job sites.
• Meet monthly productivity and QA requirements.
• Review cases with supervisors and uphold company standards and values.
• Perform additional duties as assigned.