Nurse Case Manager: Return-to-Work & Care Coordination

AF Group; Dallas (TX); On-site; USD 63,000 - 90,000; Full time

Job summary

AF Group in Dallas, TX seeks a Nurse Case Manager to apply medical knowledge in reviewing workers' compensation claims, assess treatment appropriateness, and coordinate care for timely return to work. The NCM collaborates with claim handlers and physicians to ensure optimal outcomes that align with evidence-based guidelines.

The role emphasizes patient-centered case management, proactive communication with claimants and providers, and adherence to state regulations while maintaining high service

Qualifications

• Knowledge of clinical care and jurisdictional requirements.
• Ability to stay organized and efficient in prioritizing assignments.
• Strong time management skills and professional communication.
• Proficiency with computer and Microsoft Windows Suite.

Responsibilities

• Review and manage treatment of claimants through workers' compensation per diagnosis and state regulations.
• Determine medical necessity and level of care for proposed and ongoing treatment.
• Prepare internal/external correspondence to research and resolve disputes with providers and claims handlers.
• Discuss and finalize return-to-work options and assign permanency ratings with medical providers.

Skills

Time management

Communication skills

Critical thinking

Clinical assessment

Education

RN license (active)

BSN preferred

Job description

AF Group in Dallas, TX seeks a Nurse Case Manager to apply medical knowledge in reviewing workers' compensation claims, assess treatment appropriateness, and coordinate care for timely return to work. The NCM collaborates with claim handlers and physicians to ensure optimal outcomes that align with evidence-based guidelines.

The role emphasizes patient-centered case management, proactive communication with claimants and providers, and adherence to state regulations while maintaining high service