Nurse Case Manager

SFM Mutual Insurance Company; BLOOMINGTON (MN); On-site; USD 75,000 - 104,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Hybrid work environment

401(k) with company match

Student loan repayment benefits

PTO and holidays

Job summary

SFM Mutual Insurance Company, based in Minnesota, seeks a Nurse Case Manager to manage workers’ compensation claims by phone, coordinating medical care and facilitating timely return to work. The role emphasizes high-quality service and adherence to state laws and medical best practices.

The ideal candidate holds an RN license in Minnesota (multi-state licensure preferred) with related case management or occupational health experience.

Qualifications

• RN licensure in the hired state; multi-state licensure preferred.
• Two years of experience in case management, physical rehabilitation, or occupational health.
• Worker’s compensation or casualty insurance experience preferred.
• CCM/CDMS/CRRN designations preferred.
• Five years of clinical experience preferred.
• Ability to evaluate ongoing treatment and return-to-work potential within established protocols.
• Strong knowledge of medical treatment protocols and physician advisor utilization.
• Excellent organizational skills and ability to manage multiple projects with minimal direction.
• Excellent customer service and interpersonal skills.

Responsibilities

• Provides telephonic medical case management for workers’ compensation claims, including assessment, care planning, and coordination to facilitate return to work.
• Meets with injured workers, policyholders, and medical providers in person or virtually to support outcomes and documents assessments.
• Uses return-to-work strategies with providers and policyholders based on guidelines and medical data.
• Provides education and medical treatment parameter information to facilitate recovery and return to work.
• Offers clinical guidance to the claims team on treatment timing, cost containment, and return-to-work strategies; coordinates resources as needed.
• Delivers premier customer service and resolves complaints promptly.

Skills

Case management

Customer service

Interpersonal skills

Organizational skills

Medical knowledge

Education

RN licensure in MN

Associate’s Degree (RN)

Bachelor’s degree preferred

Job description

Pay: $74,500.00 to $104,295.00; annual salary.

Ranked #8 Top Workplace– Midsize Employer, MN

About the Role:

At SFM, doing the right thing guides everything we do and gives our employees the chance to make a real difference in people’s lives. As a Nurse Case Manager, you will serve as a medical resource and educator, helping manage workers’ compensation claims. Working primarily by phone, you will provide high-quality service to injured workers and policyholders, managing the medical side of each claim and promoting a safe, timely return to work. You will partner with claims representatives as part of a multidisciplinary Business Team, using your medical expertise to help resolve medical and claim issues in a cost-effective way. You will also promote effective case management that follows medical best practice guidelines and state laws and regulations. Delivering excellent customer service to everyone involved in the claims process is central to this role and to SFM’s mission. The ideal candidate lives in Minnesota, in or near the Twin Cities area. Candidates with occupational health experience are encouraged to apply.

What You’ll Do:

• Provides telephonic medical case management for workers’ compensation claims, including assessment, care planning, and coordination of services to facilitate return to work and achieve end of healing (EOH) or maximum medical improvement (MMI) in a timely, high-quality, and cost-effective manner.
• Meets with injured workers, policyholders, and medical providers, in person or virtually, to support the best possible outcomes. Documents initial and ongoing assessments in the claim file so internal customers stay informed of case management and return-to-work progress, supporting timely claim closure.
• Utilizes effective and proactive return-to-work strategies by working with providers and policyholders to establish a plan using guidelines, medical data, resources, and functional abilities of an injured worker.
• Provides education and medical treatment parameter information regarding general healing, injury specific health information, and disability duration to internal and external customers to facilitate medical recovery, function and return to work using appropriate state and national resources, while following best practices.
• Provides clinical guidance and recommendations to the claims team on the appropriateness and timing of medical treatment, cost containment, and return-to-work strategies to bring claims to a successful and timely conclusion. Identifies and coordinates appropriate resources, including physician advisor reviews, second opinions, IMEs, ergonomic evaluations, job analyses, discharge planning, DME, and home health services, and participates in multidisciplinary claim discussions as needed.
• Provides premier customer service to all customers and complies with customer service standards. Responds promptly to resolve complaints or problems

What We’ll Like About You:

• Associate’s Degree (Bachelor’s Degree Preferred) with current RN licensure in the state hired; multi-state licensure preferred.
• Two years of relevant experience such as, Case Management, Physical Rehabilitation, or Occupational Health.
• Worker’s Compensation or casualty insurance experience preferred.
• Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS) or Certified Rehabilitation Registered Nurse (CRRN) designations preferred.
• Five years of clinical experience preferred
• Ability to evaluate ongoing treatment and return-to-work potential within established protocols and make adjustments to case management strategies as warranted.
• Strong knowledge of medical treatment protocols and physician advisor utilization
• Effective organizational skills including the ability to manage multiple projects and work with minimal direction.
• Excellent customer service and interpersonal skills

Why You’ll Love Working Here

We want your work life to feel balanced, rewarding, and supported. Here are just a few of the benefits SFM offers:

• Comprehensive medical, dental, and vision coverage (plus HSA/FSA options).
• Significant Cash Benefit if You Opt Out of Our Health Plan
• Flexible hybrid work environment.
• 401(k) with both Traditional and Roth options + company match.
• Contributions toward student loan repayment.
• Generous PTO, 9 paid holidays, and paid parental leave.
• Monthly home internet allowance.
• Free life insurance, short-term & long-term disability coverage.
• Incentive bonus opportunities.
• Discounts on gyms, fitness apps, and wellness programs.

Who We Are

SFM is the leading workers’ compensation insurer in Minnesota, with a growing presence across the Midwest. We’re proud to be recognized as a Top Workplace (#8 midsize employer in MN) thanks to our supportive culture, commitment to our employees, and focus on doing what’s right.

The base pay posted is just one component of SFM’s total compensation package. The salary range listed represents the full compensation range for this position. Job title and starting pay will be based on the selected candidate’s relevant knowledge, skills, abilities and/or experience, and education, if applicable as well as internal equity with other employees in the same job classification.

Work Environment and Physical Demands

Regular attendance is required. Work takes place in a semi paperless environment within an office setting, either on business premises or other remote location, using standard office equipment such as computers, phones, and copiers, which requires being stationary for extended periods of time. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms and work with close vision. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Work is performed indoors with little to no exposure to extreme outdoor weather conditions.

Equal Opportunity/Affirmative Action Employer

SFM Mutual Insurance Company and each of its parent companies, subsidiaries and/or affiliated companies are Equal Opportunity/Affirmative Action Employers. SFM provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, status with regard to public assistance, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

SFM Companies, EEO/AA Employers

SFM Companies, EEO/AA Employers.SFM is a participant of E-Verify.Applicants have rights under Federal Employment Laws.

Equal Opportunity Employer

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.