Remote RN Medical Case Manager for Return-to-Work

AmTrust Financial Services, Inc.; Pennsylvania; On-site; USD 80,000 - 90,000; Full time

Benefits offered by this job

Medical and Dental Plans

Life Insurance

401k Savings Plans

Paid Time Off

Job summary

AmTrust Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN to provide comprehensive telephonic case management and drive medically appropriate return to work.

The role partners with adjusters and employers, utilizing URAC standards and clinical nursing skills, with a focus on cost-effective care and patient advocacy. The position is remote in Pennsylvania, with requirements including NY RN license, BSN preferred, and potential for certification.

Qualifications

• Active unrestricted NY RN license; PA compact preferred.
• BSN preferred.
• Certification in case management, pharmacy, rehabilitation nursing or related specialty preferred.
• Spanish and English fluency preferred.

Responsibilities

• Determine whether all aspects of patient care are medically necessary; perform Utilization Review.
• Coordinate treatment with employers, providers and adjusters; develop medical resolution strategies.
• Document case management activities accurately in the CMS.
• Assist employers in modifying job duties based on medical limitations and functional assessment.
• Maintain client privacy and adhere to ethical, legal and regulatory standards.

Skills

Clinical skills

Utilization Review

Care coordination

Documentation

Spanish

Education

Active NY RN license

BSN preferred

Case management certification

Tools

Microsoft Office

Job description

AmTrust Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN to provide comprehensive telephonic case management and drive medically appropriate return to work.

The role partners with adjusters and employers, utilizing URAC standards and clinical nursing skills, with a focus on cost-effective care and patient advocacy. The position is remote in Pennsylvania, with requirements including NY RN license, BSN preferred, and potential for certification.