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

Blue Cross Blue Shield of Michigan; United States; On-site; USD 63,000 - 90,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a Nurse Case Manager to review workers’ compensation claims, coordinate treatment, and drive timely return-to-work outcomes. The role emphasizes evidence-based review, communication with claimants and physicians, and collaboration with claim handlers to resolve cases efficiently.

The ideal candidate has an active RN license, a BSN preferred, and experience in workers’ compensation or occupational health.

Qualifications

• RN license active and unrestricted required; BSN preferred.
• Continuous learning and certification encouraged.
• Experience in workers’ compensation or occupational health preferred.

Responsibilities

• Review patient status and history to determine causal relation to work injuries.
• Apply age-specific and cultural considerations during interview and intervention.
• Assess medical necessity and hospitalization needs for lost-time cases.
• Prepare correspondence to research and resolve disputes; inform claim handlers.
• Present and finalize return-to-work programs with accurate permanency ratings.
• Adhere to applicable Nurse Practice Acts and professional conduct standards.

Skills

Time management

Oral communication

Written communication

Critical thinking

Decision making

Customer service

Microsoft Windows Suite

Education

Registered Nurse license

BSN preferred

Tools

Microsoft Windows Suite

Job description

Blue Cross Blue Shield of Michigan is seeking a Nurse Case Manager to review workers’ compensation claims, coordinate treatment, and drive timely return-to-work outcomes. The role emphasizes evidence-based review, communication with claimants and physicians, and collaboration with claim handlers to resolve cases efficiently.

The ideal candidate has an active RN license, a BSN preferred, and experience in workers’ compensation or occupational health.