Medical Field Case Manager

Genex Services; Fremont (CA); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a compassionate team dedicated to making a positive impact on injured individuals' lives. In this full-time, work-from-home position, you will serve as a Field Case Manager, collaborating with healthcare providers, employers, and patients to develop tailored treatment plans. Your expertise in case management and clinical practice will be crucial in guiding patients toward recovery and a successful return to work. Enjoy a comprehensive benefits package, including generous vacation days and training opportunities, while making a meaningful difference in the lives of those you serve.

Benefits

Full and comprehensive benefits program

24 days of paid vacation/holidays

Home office equipment

Mileage and travel reimbursement

Employee Assistance Program

Hands-on case management training

Qualifications

• 5+ years of clinical practice and workers’ compensation experience required.
• Active RN license and URAC-recognized certification in case management required.

Responsibilities

• Create and implement treatment plans for injured/disabled persons.
• Collaborate with physicians and employers to facilitate early return to work.

Skills

Clinical Practice

Case Management

Advocacy Skills

Communication Skills

Computer Skills (Excel, Word, Outlook)

Education

Associates Degree in Nursing

Bachelor’s Degree in Nursing

Tools

Microsoft Excel

Microsoft Word

Outlook Email

Job description

Company Overview

The Enlyte Family of Businesses

Mitchell | Genex | Coventry

Enlyte is the parent brand of Mitchell, Genex, and Coventry, an organization unlike any other in the Property & Casualty industry. It brings together three great businesses with a shared vision of using technology innovation, clinical services, and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events while providing opportunities for meaningful impact and career growth.

Job Description

This is a full-time, work-from-home position. The candidate must be located in the Fremont, CA area due to regular local travel for in-person patient appointments.

Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers’ compensation case management training.

Join our compassionate team and help make a positive difference in an injured person’s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensures appropriate and cost-effective healthcare services, achieves maximum medical recovery, and facilitates return to an optimal level of work and functioning. In this role, you will:

• Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
• Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.
• Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.
• Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to individual patients.
• Work with employers and physicians to modify job duties where practical to facilitate early return to work.
• Evaluate and modify case goals based on the injured/disabled person’s improvement and treatment effectiveness.
• Manage workload independently, including prioritizing cases and managing them effectively.
• Complete other duties such as attending injured workers’ appointments when appropriate, preparing status updates for submission to customers, and other responsibilities as assigned.

Qualifications

• Education: Associates Degree or Bachelor’s Degree in Nursing or related field.
• Experience: 5+ years of clinical practice required; workers’ compensation-related experience required.
• Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Ability to mentor and/or train other case managers as needed. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient in grammar, sentence structure, and written communication skills.
• Certifications, Licenses, Registrations:
  • Active Registered Nurse (RN) license required, in good standing.
  • URAC-recognized certification in case management required (e.g., CCM, CDMS, CRC, CRRN, COHN, COHN-S, RN-BC, ACM, CMAC, CMC).
• Travel: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in the assigned geography.
• Internet: Must have reliable internet connection.