Remote RN Medical Case Manager — Telephonic Care & Return-to-Work

AmTrust Financial Services, Inc.; United States; 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, Inc. is seeking a Telephonic Medical Case Manager, RN, to provide comprehensive, compassionate telephonic case management for injured employees.

You will collaborate with adjusters, providers, and employers to develop individualized plans that promote timely return to work and appropriate care. Responsibilities include utilization review, care coordination, and documentation, with opportunities for Spanish/English fluency and ongoing professional certification.

Qualifications

• Active unrestricted RN license in the state you reside.
• BSN from an accredited college or university or equivalent work experience preferred.
• Certification in case management, pharmacy, rehabilitation nursing or related specialty is highly preferred.
• Ability to acquire and maintain professional certifications to comply with state laws.
• Preferred licenses to be obtained within 3–6 months of starting.
• Written and verbal fluency in Spanish and English preferred.

Responsibilities

• Determine medical necessity across care levels and ensure appropriate delivery of services.
• Perform Utilization Review prospectively, concurrently or retrospectively per guidelines.
• Maintain accurate, comprehensive documentation in the case management system.
• Coordinate treatment plans with providers, employers and adjusters to facilitate return to work.
• Engage specialty resources as needed to optimize resolution (behavioral health, physician advisor).
• Communicate effectively with claims adjuster, client, vendor, and other parties.

Skills

Case management

URAC standards

Disability guidelines

Spanish bilingual

Communication

Analytical skills

Leadership

Teamwork

Education

RN license

BSN

Case management certification (preferred)

Tools

Microsoft Office

Job description

AmTrust Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN, to provide comprehensive, compassionate telephonic case management for injured employees.

You will collaborate with adjusters, providers, and employers to develop individualized plans that promote timely return to work and appropriate care. Responsibilities include utilization review, care coordination, and documentation, with opportunities for Spanish/English fluency and ongoing professional certification.