Medical Case Manager

Crawford & Company; Naples (FL); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated RN for a work-from-home position focused on case management. This role requires local travel to provide essential services across Southwest Florida, ensuring effective medical case resolutions. The ideal candidate will have a strong background in nursing, excellent communication skills, and a passion for helping individuals navigate their recovery journeys. With a culture that values respect and collaboration, this opportunity offers a supportive environment for professional growth and development. Join a team that believes every claim tells a story and is committed to making a difference in the lives of those they serve.

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 and minimum of one national certification required.
• 1-3 years of clinical experience preferred, with knowledge of case management practices.

Responsibilities

• Provide effective case management services adhering to URAC and CMSA Standards.
• Travel approximately 70% of work time to various locations for case management.

Skills

Case Management

Communication Skills

Analytical Skills

Organizational Skills

Leadership Skills

Education

RN Degree

Associate's Degree in Nursing

BSN

Tools

Microsoft Office

Lotus Notes

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 field case management travel to cover the Southwest, FL, including Fort Myers, Naples, and surrounding regions.

Minimum Requirements

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

Job Responsibilities

• Provide effective case management services in a cost-effective manner, adhering to URAC, CMSA Standards of Practice, and Broadspire QA Guidelines for various insurance lines.
• Review case records, analyze data, evaluate medical status, and identify needs and obstacles to medical case resolution and RTW.
• Render opinions on case costs, treatment plans, and outcomes, and make recommendations to facilitate case management goals.
• Maintain administrative standards, including productivity, time management, and QA standards.
• Perform job site evaluations to facilitate case management.
• Establish professional relationships with injured workers, physicians, and employers to facilitate RTW.
• Communicate with claims adjusters and other parties involved in case management.
• Review files, make referrals, and interpret medical records and test results.
• Travel approximately 70% of work time to homes, healthcare providers, job sites, and offices.
• Meet monthly production and QA requirements.
• Uphold company code of conduct and demonstrate excellent customer service.
• Perform other related duties as assigned.

Qualifications

• Associate's degree or relevant coursework in Nursing; BSN preferred.
• 1-3 years clinical experience.
• Certification as a case manager (preferred) or RN license.
• Minimum of 1 national certification (CCM, CDMS, CRRN, COHN); plan to obtain if not already certified.
• Active RN license in good standing.
• Travel readiness and valid driver's license.
• Knowledge of case management practices, excellent communication, analytical, organizational, and leadership skills.
• Computer skills including Microsoft Office and Lotus Notes.

Why Crawford?

Because a claim is more than a number—it's a person. At Crawford, employees are empowered to grow, act, and innovate, serving communities and fostering a culture of respect, collaboration, and inclusion. Learn more at www.crawco.com.