Remote Nurse Case Manager – Workers' Comp

Encova Insurance; Charleston (WV); Hybrid; USD 55,000 - 111,000; Full time

Benefits offered by this job

Health, dental & vision insurance

401(k) with company match

Paid time off & holidays

Hybrid and remote depending on role

Job summary

Encova Insurance is seeking a Nurse Case Manager to serve as an office-based medical resource for workers' compensation claims, primarily telephonically. The role emphasizes high-quality customer service and expertise in case management and utilization review.

Responsibilities include medical assessments, planning, and coordination with providers to manage costs and support injured workers’ recovery. A registered nurse with relevant experience is required, with multi-state practice and strong

Qualifications

• Licensed Registered Nurse with no restrictions.
• Associate degree in nursing or diploma nursing program required; bachelor’s/master’s preferred.
• One year of nurse case management, medical case management or utilization review required; workers' comp experience preferred.
• National certification in case management or occupational health may substitute for one year of experience.
• Two years of clinical experience in orthopedics, neurology, rehabilitation, internal medicine or occupational medicine.
• Multi-state case management experience desired.
• Bilingual ability is a plus.
• Strong information-gathering, analytical and solution-focused skills.
• Knowledge of evidence-based treatment guidelines and medical causation.
• Ability to coordinate medical treatment while containing costs.
• Ability to collaborate with multiple teams and stakeholders.
• Strong planning and organizational skills.
• Knowledge of medical case management practices and trends.
• Excellent oral and written communication skills.
• Diplomacy, compassion and professional competency.
• Proficiency in Word, Outlook and Excel; able to learn new systems.

Responsibilities

• Perform early medical management assessment on workers' compensation claims.
• Contact injured workers and providers to obtain information.
• Apply guidelines to evaluate claims and craft proactive action plans.
• Manage medical case activities within approved treatment plans.
• Contain costs through utilization management and provider resources.
• Coordinate with team to expedite return-to-work and reduce disability costs.
• Identify and monitor claims for field assignments.
• Ensure accurate diagnoses and document actions/outcomes.
• Adhere to jurisdictional regulations and standards.
• Deliver high quality service in a team-based environment.

Skills

Registered Nurse

Communication skills

Team collaboration

Multitasking

Education

Associate degree in nursing

Bachelor’s or Master’s in Nursing preferred

Diploma nursing program

Tools

Word

Outlook

Excel

Job description

Encova Insurance is seeking a Nurse Case Manager to serve as an office-based medical resource for workers' compensation claims, primarily telephonically. The role emphasizes high-quality customer service and expertise in case management and utilization review.

Responsibilities include medical assessments, planning, and coordination with providers to manage costs and support injured workers’ recovery. A registered nurse with relevant experience is required, with multi-state practice and strong