Nurse Case Manager I

International Medical; Indianapolis (IN); Hybrid; USD 60,000 - 100,000; Full time

Job summary

An established industry player in international medical insurance seeks a dedicated RN to join their team. This role involves evaluating healthcare services, performing utilization reviews, and liaising between insured clients and healthcare providers. With hybrid or remote working options, you will enjoy a supportive work environment that values flexibility and professional growth. The company offers comprehensive benefits, including medical, dental, and vision insurance, along with a 401k plan and paid time off. If you are passionate about improving healthcare experiences for travelers, this opportunity is perfect for you.

Benefits

Comprehensive benefits including Medical, RX, Dental, and Vision insurance

401k Plan with company match

Paid Time Off and Holidays

Free employee parking

On-site fitness center

Casual dress environment

Qualifications

• Active RN license in Indiana required.
• Minimum two years of hospital-based patient care experience.

Responsibilities

• Evaluate medical necessity and act as a liaison between insured and healthcare team.
• Perform certifications and manage inpatient and outpatient cases.

Skills

Communication Skills

Problem-Solving

Clinical Judgment

Customer Service

Organizational Skills

Education

RN License

B.S.N. (preferred)

Tools

Microsoft Word

Microsoft Excel

Internet

Job description

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of all sizes. Every second of every day, vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence use our products to give themselves global peace of mind.

We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for travelers.

JOB DETAILS

• RN License: Must have an active RN license in good standing in Indiana.
• Location: Hybrid or remote working options. Corporate office is in Indianapolis, IN.
• Relocation Expenses: Reimbursed: No
• Legal Authorization: Qualified candidates must be legally authorized to be employed in the United States. IMG will not be providing sponsorship for employment visas (e.g., H-1B or TN).

JOB SUMMARY

Evaluate medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities for utilization review and/or evacuation/repatriation. Act as a liaison between the insured, the insurance carrier, and the healthcare team to meet policy requirements in the U.S. and abroad.

PERKS

• Comprehensive benefits including Medical, RX, Dental, and Vision insurance
• 401k Plan with company match
• Paid Time Off and Holidays
• Free employee parking
• On-site fitness center
• Casual dress environment

DUTIES AND RESPONSIBILITIES

• Perform certifications, concurrent, retrospective reviews, and medical evacuations/repatriations, managing inpatient and outpatient cases.
• Understand the non-certification and appeals processes, including logs and timeframes.
• Participate in on-call rotation.
• Provide pre-travel advice via phone and email.
• Guide members to in-network providers and negotiate discounts with out-of-network providers.
• Suggest alternative care settings when appropriate.
• Identify large case management opportunities and refer accordingly.
• Document case information accurately in management systems.
• Prepare reports as needed, using good judgment and consulting the Medical Director when appropriate.
• Communicate effectively with team members and maintain confidentiality of protected health information.
• Engage in continuous education and support quality management activities.
• Stay informed on applicable regulations and report complaints as needed.
• Perform any other assigned duties.

QUALIFICATIONS

• Current and active RN license
• Minimum two years of hospital-based patient care experience
• Proficient in computer skills, including Internet, Word, and Excel.

PREFERRED SKILLS

• B.S.N. preferred
• At least two years' utilization review experience with managed care or insurance
• Proficiency in a foreign language is a plus
• Experience auditing medical charts against bills

PROFESSIONAL COMPETENCIES

• Excellent communication skills, clear and persuasive
• Proactive problem-solving and process improvement mindset
• Good clinical judgment
• Flexibility to adapt to industry changes
• Strong teamwork and professional representation
• Exceptional customer service and organizational skills

WORK CONDITIONS

• Office setting
• Comfortable in a desk environment
• Majority of time spent sitting, using keyboard and mouse

IMG is committed to diversity and equal opportunity employment. All qualified applicants will be considered without regard to race, color, ethnicity, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, or other protected statuses as per law.