Remote RN Case Manager: Return-to-Work & Care Coordination

AmTrust Financial Services Inc.; Boston (MA); Remote; USD 80,000 - 90,000; Full time

Benefits offered by this job

Medical & Dental Plans

Life Insurance

Health Care Flexible Spending

Dependent Care

401k Savings Plans

Paid Time Off

Job summary

AmTrust Financial Services seeks a Telephonic Medical Case Manager (RN) to deliver comprehensive telephonic case management and drive appropriate return-to-work outcomes. You will collaborate with injured employees, providers, and adjusters to tailor holistic care and may oversee pharmacy oversight and utilization review.

The role emphasizes documentation, regulatory compliance, and coordinated care, with a remote work option in Pennsylvania or Massachusetts.

Qualifications

• Active unrestricted RN license in required state; PA compact preferred.
• BSN from accredited college or university or equivalent experience preferred.
• Certification in case management, pharmacy, rehabilitation nursing or related specialty preferred.
• Ability to acquire/maintain professional licenses to comply with state laws.

Responsibilities

• Provide comprehensive telephonic case management to drive medically appropriate return to work.
• Perform utilization review activities prospectively, concurrently or retrospectively.
• Maintain accurate documentation in case management system.
• Coordinate treatment to maximize quality and cost-effectiveness of care.
• Collaborate with employer, injured employee and provider on job modifications.
• Support claims adjusters with medical treatment and reserve input.
• Engage specialty resources to achieve optimal resolution when needed.
• Maintain client privacy and adhere to regulatory standards.

Skills

Utilization review

Case management

Nursing assessment

Care coordination

Pharmacy oversight

Communication skills

Documentation

Regulatory knowledge

Education

RN license (active)

BSN preferred

Case management certification preferred

Bilingual Spanish/English preferred

Tools

Microsoft Office

Case management system

Pharmacy systems

Job description

AmTrust Financial Services seeks a Telephonic Medical Case Manager (RN) to deliver comprehensive telephonic case management and drive appropriate return-to-work outcomes. You will collaborate with injured employees, providers, and adjusters to tailor holistic care and may oversee pharmacy oversight and utilization review.

The role emphasizes documentation, regulatory compliance, and coordinated care, with a remote work option in Pennsylvania or Massachusetts.