Remote Nurse Case Manager, Workers' Comp - Return to Work

TalentLNX; Northern (KY); On-site; USD 75,000 - 92,000; Full time

Job summary

TalentLNX seeks a Nurse Case Manager for Workers' Compensation to manage occupational injury claims from referral through return to work, in a fully remote role across the United States. The RN will apply clinical judgment to disability outcomes, coordinate authorizations, and collaborate with employers, adjusters, physicians, and counsel to move claims forward.

ADN is required with BSN preferred; active multi-state RN license; 3 years nursing and 2 years WC case management; CCM/CRRN/COHN

Qualifications

• ADN required; BSN preferred; multi-state license required or willingness to obtain
• Minimum 3 years of clinical nursing experience
• Minimum 2 years of workers compensation case management experience (telephonic or field)
• CCM/CRRN/COHN certification preferred, CCM strongly preferred
• Clinical background in orthopedics, occupational health, rehabilitation, emergency medicine, or neurology

Responsibilities

• Manage 60 to 90 active workers compensation claims from injury referral through return to work or MMI
• Assess functional capacity, psychosocial barriers, treatment compliance, and return-to-work readiness
• Develop individualized case plans with physicians, therapists, and vocational rehabilitation consultants
• Review medical records against evidence-based guidelines to identify care gaps
• Coordinate authorizations for referrals, surgery, durable medical equipment, home health, and pharmacy management
• Partner with employers to develop modified duty and return-to-work programs
• Serve as liaison between injured workers, adjusters, employers, counsel, and treating providers
• Document case activity and outcomes in the claims management platform

Skills

Case management

Negotiation

Documentation

Stakeholder communication

Education

ADN

BSN (preferred)

Tools

Juris

Guidewire

Majesco

Job description

TalentLNX seeks a Nurse Case Manager for Workers' Compensation to manage occupational injury claims from referral through return to work, in a fully remote role across the United States. The RN will apply clinical judgment to disability outcomes, coordinate authorizations, and collaborate with employers, adjusters, physicians, and counsel to move claims forward.

ADN is required with BSN preferred; active multi-state RN license; 3 years nursing and 2 years WC case management; CCM/CRRN/COHN