Remote Medical Case Manager — Telephonic Workers' Comp

TRISTAR MANAGED CARE INC; Summerville (SC); Remote; USD 70,000 - 95,000; Full time

Job summary

TRISTAR MANAGED CARE INC. is seeking a Medical Case Manager to provide telephonic case management in a workers’ compensation environment, coordinating resources and cost-effective options to support treatment goals and return-to-work planning.

The role emphasizes excellent communication, independent work, and detailed documentation, including initial assessments, care plans, and coordination with providers, claimants, and employers.

Qualifications

• Diploma, Associate or Bachelor’s degree in Nursing; Master’s level in Nursing or Health/ Human Services preferred.
• Current unrestricted nursing license (RN or LPN) required.
• CCM, CMCN, CPUR, CPDM, COHN or CDMS certifications preferred.

Responsibilities

• Provide telephonic outreach for assessment and follow-up for case communication and coordination.
• Develop and implement clinical case plans with injured workers, employers and providers.
• Coordinate contact with providers, claimants, RTW teams and claims examiners.
• Review records, analyze data, assess medical status, and ensure timely RTW planning.

Skills

Communication

Organizational skills

Independent work

MS Office

Problem solving

Education

Nursing degree

RN/LPN license

CCM certification desired

Tools

Electronic records

Job description

TRISTAR MANAGED CARE INC. is seeking a Medical Case Manager to provide telephonic case management in a workers’ compensation environment, coordinating resources and cost-effective options to support treatment goals and return-to-work planning.

The role emphasizes excellent communication, independent work, and detailed documentation, including initial assessments, care plans, and coordination with providers, claimants, and employers.