Remote Nurse Case Manager: Return-to-Work Focus

Berkley Medical Management Solutions (a Berkley Company); Manassas (VA); On-site; USD 75,000 - 88,000; Full time

Benefits offered by this job

Health benefits

Dental benefits

Vision benefits

Life insurance

Disability insurance

Wellness program

Paid Time Off

401(k) and Profit-Sharing

Job summary

Berkley Medical Management Solutions (BMMS) seeks a Telephonic Nurse Case Manager to assess, plan, coordinate, monitor, evaluate, and implement options to facilitate timely medical care and return-to-work outcomes for injured workers.

The role requires RN licensure with 2+ years in workers’ compensation and medical case management; CCM is preferred. Expect collaboration with employers, adjusters, physicians, and providers across multiple jurisdictions.

Qualifications

• Minimum 2 years of experience in workers' compensation insurance and medical case management preferred.
• Minimum of 4 years medical/surgical clinical experience required.
• Exhibit strong communication skills, professionalism, flexibility and adaptability.
• Working knowledge of medical and vocational resources available to the Workers’ Compensation industry.
• Demonstrate self-motivation and ability to perform case management duties independently.
• Demonstrate computer and technology skills; bilingual in Spanish a plus.

Responsibilities

• Coordinate and implement medical case management to facilitate case closure.
• Maintain timely and comprehensive communication with employers, adjusters and injured workers.
• Assess appropriate utilization of medical treatment and services via physicians and specialists.
• Review medical records and data to ensure progress and guide case movement to closure.
• Manage assigned caseloads, varying by state jurisdiction and territory.
• Obtain and maintain RN licensure in required jurisdictions; pursue CCM within 2 years.
• Coordinate services including home care, equipment, IMEs, admissions, discharges, and vocational services.
• Document activities and progress using best-practice tools for quality improvement.
• Review job analyses with providers to coordinate return-to-work plans.
• Engage in special projects and attend on-site meetings as needed.
• Foster a teamwork environment and support colleagues.
• Maintain and update evidence-based medical guidelines (ODG, MD Guidelines) as case plans evolve.
• Sponsoring state certifications/licensures as required.

Skills

Strong communication

Bilingual Spanish/English

Computer skills

Adaptability

Self-motivation

Education

RN license

CCM certification preferred

Bachelor of Nursing preferred

RN compact license preferred

Tools

EHR systems

Job description

Berkley Medical Management Solutions (BMMS) seeks a Telephonic Nurse Case Manager to assess, plan, coordinate, monitor, evaluate, and implement options to facilitate timely medical care and return-to-work outcomes for injured workers.

The role requires RN licensure with 2+ years in workers’ compensation and medical case management; CCM is preferred. Expect collaboration with employers, adjusters, physicians, and providers across multiple jurisdictions.