Remote Nurse Case Manager – Workers' Comp

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

Benefits offered by this job

Health, dental & vision insurance

Company-provided life insurance

Incentive bonus program

401(k) match

PTO and holidays

Hybrid/remote flexibility

Job summary

Encova Mutual Insurance Group seeks a Nurse Case Manager to serve as an office-based medical resource for workers' compensation claims, primarily telephonically. You will provide medical expertise and support in cost containment of medical and indemnity expenses.

The role requires active RN licensure, nursing degree, and 1+ year in nurse case management with workers' compensation experience preferred; multi-state experience is desired and certifications may substitute for experience.

Qualifications

• Licensed Registered Nurse with no restrictions.
• Minimum of an Associate degree in nursing or completion of a diploma program.
• Bachelor’s or Master’s degree in nursing preferred.
• One year of nurse case management or related experience required; workers' compensation preferred.
• Nationally recognized specialty certification in occupational or rehabilitative nursing or case management
• Two years of clinical experience in orthopedics, neurology, rehabilitation, internal medicine, or occupational medicine.
• Multi-state case management experience is desired.

Responsibilities

• Complete early medical management assessment and intervention on workers' compensation claims.
• Apply knowledge and guidelines to evaluate claims and provide a proactive action plan.
• Perform medical case management activities within accepted treatment guidelines.
• Address medical cost containment through utilization management and collaboration with providers.
• Expedite injured worker recovery and return to work to reduce disability costs.
• Document recommendations, actions and outcomes.

Skills

RN license

Case management

Utilization review

Nursing degree

Education

Associate degree in nursing

Bachelor’s degree preferred

Master’s degree preferred

Tools

Word

Outlook

Excel

Job description

Encova Mutual Insurance Group seeks a Nurse Case Manager to serve as an office-based medical resource for workers' compensation claims, primarily telephonically. You will provide medical expertise and support in cost containment of medical and indemnity expenses.

The role requires active RN licensure, nursing degree, and 1+ year in nurse case management with workers' compensation experience preferred; multi-state experience is desired and certifications may substitute for experience.