Nurse Case Manager - Workers' Comp & RTW Advocate

AF Group; Philadelphia (Philadelphia County); On-site; USD 63,000 - 90,000; Full time

Job summary

AF Group seeks a Nurse Case Manager to apply medical knowledge in reviewing workers' compensation claims, evaluating treatment plans, and overseeing care to drive timely return to work. The role involves coordinating with claimants, physicians, and handlers to ensure evidence-based, policy-aligned decisions.

The ideal candidate will hold an active RN license with BSN preferred, plus at least three years of clinical care and workers' compensation experience or related fields.

Qualifications

• RN license active and unrestricted required.
• BSN degree preferred.
• Continuous learning required as defined by the company's philosophy.
• Certification or progress toward certification encouraged.

Responsibilities

• Review and approve treatment plans for workers' compensation claims to ensure medical necessity and appropriateness.
• Coordinate claimant care with providers and claim handlers to facilitate timely return to work.
• Assess medical status and determine need for inpatient vs. outpatient care.
• Document and communicate decisions and potential ramifications to claims team.
• Ensure adherence to state workers' compensation regulations and professional conduct standards.

Skills

Clinical care knowledge

Time management

Communication

Critical thinking

MS Windows

Education

Registered Nurse license

BSN preferred

Tools

Microsoft Office

Job description

AF Group seeks a Nurse Case Manager to apply medical knowledge in reviewing workers' compensation claims, evaluating treatment plans, and overseeing care to drive timely return to work. The role involves coordinating with claimants, physicians, and handlers to ensure evidence-based, policy-aligned decisions.

The ideal candidate will hold an active RN license with BSN preferred, plus at least three years of clinical care and workers' compensation experience or related fields.