Nurse Case Manager – Workers' Comp & Return-to-Work

AF Group; Winston-Salem (NC); On-site; USD 63,000 - 90,000; Full time

Job summary

AF Group in Winston-Salem, NC is seeking a Nurse Case Manager to assess and coordinate care for workers' compensation claims in line with evidence-based guidelines.

You will review medical status, determine treatment necessity, and collaborate with claim handlers to facilitate timely return to work while maintaining high levels of customer service.

Qualified RNs with 3+ years in case management or comparable roles are preferred; BSN is a plus, and ongoing certification is encouraged.

Qualifications

• Registered Nurse license active and unrestricted.
• BSN preferred.
• Three years of clinical care experience as a Registered Nurse.
• Three years workers' compensation case management or related experience preferred.

Responsibilities

• Review and manage treatment of claimants through the workers' compensation system.
• Obtain and review patient status to determine causality of symptoms related to work injuries.
• Determine medical necessity and reasonableness of proposed and ongoing treatment; assess inpatient/outpatient care.
• Prepare and finalize internal and external correspondence for case disputes and inquiries.
• Coordinate return-to-work programs and ensure accurate permanency ratings with medical providers.

Skills

Time management

Written report preparation

Communication skills

Critical thinking

Clinical judgment

Decision making

Attention to detail

Teamwork

Customer service

Education

RN license

BSN preferred

Tools

Microsoft Windows Suite

Job description

AF Group in Winston-Salem, NC is seeking a Nurse Case Manager to assess and coordinate care for workers' compensation claims in line with evidence-based guidelines.

You will review medical status, determine treatment necessity, and collaborate with claim handlers to facilitate timely return to work while maintaining high levels of customer service.

Qualified RNs with 3+ years in case management or comparable roles are preferred; BSN is a plus, and ongoing certification is encouraged.