Nurse Case Manager - Pittsburgh, PA

TRIUNE Health Group; Pittsburgh (Allegheny County); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Time Off: 20 days vacation + 8.5 paid

401(k) match

Medical, dental, vision

Disability: STD/LTD

Employee Assistance Program

Work-from-Home equipment

Travel reimbursement

Job summary

TRIUNE Health Group is seeking a Nurse Case Manager to coordinate care for catastrophically or chronically ill or injured individuals, with a focus on timely return to work. You will collaborate with patients, physicians, employers, and referral sources to design cost-effective, holistic treatment plans.

The role requires RN licensure, 3+ years of clinical experience, and strong communication skills. Travel up to 90% and HIPAA compliance are essential.

Qualifications

• Graduation from an accredited nursing program.
• Current RN licensure in the operating state.
• CCM certification preferred but not required.

Responsibilities

• Provide medical case management through coordination with patient, physicians, and employers.
• Apply case management steps: assessment, planning, implementation, evaluation, and outcomes.
• Evaluate treatment plans for medical necessity and cost-effectiveness.

Skills

Leadership

Verbal and written communication

Analytical skills

Multitasking

Microsoft Office Suite

Education

RN licensure (state)

BSN or higher

CCM preferred

Tools

Microsoft Office

Case management software

Job description

Location: Pittsburgh, PA

Job Id:203

# of Openings:0

About TRIUNE Health Group

TRIUNE Health Group is a nationally recognized managed healthcare company with over 35 years of experience. As a mission-driven, second-generation family-owned business, we are dedicated to improving lives by reducing the impact of injuries, enhancing health and wellness, and lowering healthcare and workers' compensation costs.

At TRIUNE, we believe that every team member is essential to our success. We foster a supportive and collaborative environment where employees are valued, empowered, and provided with the tools they need to thrive—both professionally and personally.

Why Join TRIUNE Health Group as a Nurse Case Manager?

• Be part of a well-established, family-owned company that prioritizes people over profits.
• Experience our culture of People Helping People, where every team member is treated with dignity and respect.
• Enjoy the stability, support, and resources needed to succeed while maintaining a healthy work-life balance.
• Generous Time Off: 20 days of vacation plus 8.5 paid holidays
• Retirement Savings: 401(k) match to help you plan for the future
• Comprehensive Insurance: Medical, dental, and vision coverage
• Disability Coverage: Short-Term (STD) and Long-Term Disability (LTD) insurance
• Employee Support: Employee Assistance and Referral Program
• Work-from-Home Essentials: Home office equipment, including a laptop and desktop monitor
• Travel Perks: Mileage and travel reimbursement

TRIUNE Health Group is an equal opportunity employer and a values-driven organization. Compensation is competitive and commensurate with experience.

I. Summary of Position:

The Nurse Case Manager coordinates resources and creates flexible, cost-effective options for catastrophically or chronically ill or injured individuals to facilitate quality, individualized, holistic treatment goals, including timely return to work when appropriate.

II. Essential Duties and Responsibilities:

• Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer, and the referral source.
• Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation, and outcome of an individual’s progress.
• Evaluate individual treatment plans for appropriateness, medical necessity, and cost-effectiveness.
• Facilitate care, such as negotiating and coordinating the delivery of durable medical equipment and home health services, ensuring clear communication.
• Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate architectural assessments of patients’ homes when required.
• Communicate medical information clearly and compassionately to patients and families.
• Stay current with medical terminology and the federal and state laws related to health care, Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
• Utilize technology (computer, cell phone, fax, and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPAA.
• Research medical and community resources for individuals with catastrophic or chronic diagnoses, such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, and burns, ensuring accessibility for individuals.
• Possess a valid driver’s license with the ability to travel 90% of the time.
• Perform other duties as assigned.

III. Job Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills and Abilities:

• Proven leadership skills.
• Excellent verbal and written communication skills, including the ability to interact effectively with patients, customers, and fellow employees via phone, email, in-person, and formal presentations.
• Methodical in accomplishing job-related goals.
• Strong analytical and organizational skills, including the ability to multitask with attention to detail.
• In-depth knowledge of multi-software packages, notably Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and the Internet.
• Maintain a friendly, professional attitude at all times.
• Exercise initiative and be solution-oriented, while keeping management up-to-date on current situations or opportunities.
• Dependability and adaptability.

Education and Experience:

• Graduate of an accredited school of nursing.
• Current RN licensure in the state of operation.
• Fluency in English (speaking, reading, and writing).
• Three or more years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, and neurology.
• CCM preferred.

Certificates, Licenses, Registrations:

The state board requires one or more or a combination of the following certifications: CCM, CRC, CRRN, LPC, COHN, COHN-S or CDMS.

IV. Physical Demands:

This position primarily involves sedentary work requiring prolonged periods of sitting, computer use, typing, and telephone communication. Employees must be able to regularly operate standard office equipment including computers, keyboards, phones, and printers. The position occasionally requires standing, walking, and driving for field visits or meetings, depending on business needs and position assignment.

Reasonable accommodations or modified duties, including telephonic case management, may be available where appropriate.

The role may occasionally require lifting, carrying, or transporting lightweight work materials such as laptops, files, or office supplies generally weighing no more than 10 pounds.

The position requires the ability to communicate effectively, maintain sustained concentration, and perform repetitive hand and wrist movements associated with computer and keyboard use.

The base salary range/hourly rate listed is dependent on job-related, non-discriminatory factors such as experience, education, and skills. This position is also eligible for incentive compensation awards.

You may be eligible for the following competitive benefits: medical, dental, vision, life, accident & disability, short and long-term disability, paid holidays, paid time off and 401 (k).