Medical Case Manager Part-Time

Crawford & Company; San Antonio (TX); Hybrid; USD 45,000 - 70,000; Part time

Job summary

An established industry player is seeking a dedicated Case Manager to provide exceptional case management services within the healthcare sector. This part-time position offers the flexibility of working from home while requiring local travel for field case management. Ideal candidates will possess an RN degree and relevant certifications, along with strong analytical and communication skills. Join a supportive team that values collaboration and continuous learning, and take advantage of a comprehensive benefits package including a quarterly bonus program and reimbursement for licenses. If you're passionate about making a difference in people's lives, this opportunity is 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 national certification preferred.
• 1-3 years clinical experience in case management is preferred.

Responsibilities

• Provide effective case management services adhering to URAC standards.
• Manage cases across various insurance lines including Workers' Compensation.
• Coordinate RTW efforts by establishing relationships with injured workers.

Skills

Case Management

Communication Skills

Analytical Skills

Organizational Skills

Nursing License

Workers' Compensation Knowledge

Education

RN Degree

Associate's Degree or Relevant Nursing Coursework

BSN

Job description

Benefits and Position Overview

* Great Work Life Balance!

* Quarterly Bonus Program!

* Free CEUs for licenses and certificates

* License and national certification reimbursement

This is a part-time work-from-home position requiring local travel within the Houston, TX region for field case management.

Minimum Qualifications

• RN degree required
• National Certification such as CCM, CRC, COHN, CRRC preferred
• Prior Workers' Compensation Case Management experience preferred

Job Responsibilities

Provide effective case management services in a cost-effective manner, adhering to URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. Manage cases across various insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management.

1. Review case records, analyze data, evaluate medical status, and identify needs to facilitate case resolution and return-to-work (RTW).
2. Offer opinions on case costs, treatment plans, outcomes, and recommend strategies to meet case management goals.
3. Meet administrative standards independently, including productivity and QA.
4. Perform site evaluations if necessary.
5. Coordinate RTW efforts by establishing relationships with injured workers, physicians, and employers.
6. Maintain communication with claims adjusters and involved parties.
7. Assist in obtaining medical records and reviews for case appropriateness.
8. Facilitate referrals for peer reviews and IMEs, managing medical documentation and communication.
9. Travel approximately 70% of the time to various locations for case facilitation.
10. Meet monthly production and QA standards.
11. Review cases with supervisors regularly.
12. Uphold company standards and demonstrate excellent customer service.
13. Perform other duties as assigned.

Qualifications and Skills

• Associate's degree or relevant nursing coursework; BSN preferred.
• 1-3 years clinical experience; certification as a case manager from URAC preferred or RN license.
• Knowledge of case management practices and workers' compensation services.
• Strong communication, analytical, organizational, and computer skills.
• Ability to build collaborative relationships and analyze data for improvement.
• Must be compliant with vaccination requirements if applicable, and hold a valid RN license.
• Minimum of 1 national certification (e.g., CCM, CDMS, CRRN, COHN); plan to obtain within 36 months if not already certified.
• Must maintain a valid driver's license and be willing to travel extensively.

Why Choose Crawford?

Because a claim is more than a number—it's a person. At Crawford, we empower employees to grow, innovate, and lead in a global community that values respect, collaboration, and continuous learning. Our comprehensive benefits include performance-based incentives, wellness programs, career development, and community engagement initiatives. Join us and be part of the "One Crawford" family.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. We do not accept unsolicited resumes from search firms unless a valid agreement is in place.