Remote RN Medical Case Manager – Telephonic UM

AmTrust Financial Services Inc.; Boca Raton (FL); Remote; USD 80,000 - 88,000; Full time

Job summary

AmTrust Financial Services is seeking a Telephonic Medical Case Manager, RN, to provide comprehensive remote case management in Florida or Georgia. The role focuses on driving medically appropriate return to work through engagement with injured employees, providers, and employers.

Utilizes review, care coordination, and collaboration with adjusters to develop personalized plans. The position requires an active RN license, 3+ years of related experience, and preferred certifications in case

Qualifications

• Active unrestricted RN license in the United States.
• BSN preferred or equivalent work experience.
• Certification in case management or related specialty preferred.
• Spanish and English fluency preferred.

Responsibilities

• Apply nursing skills to determine medical necessity of care.
• Perform utilization review prospectively, concurrently, or retrospectively.
• Notify physicians and coordinate with physician advisor as needed.
• Accurately document case management activities in the system.
• Coordinate treatment plans and return-to-work with employers and providers.
• Assist in modifying job duties based on medical limitations.
• Ensure appropriate level and intensity of care per guidelines.
• Communicate with claims adjusters, clients, and vendors to coordinate care.

Skills

Clinical assessment

Care coordination

Utilization review

Communication skills

Team collaboration

Education

RN license

BSN preferred

CM/related certification preferred

Tools

Case management system

Job description

AmTrust Financial Services is seeking a Telephonic Medical Case Manager, RN, to provide comprehensive remote case management in Florida or Georgia. The role focuses on driving medically appropriate return to work through engagement with injured employees, providers, and employers.

Utilizes review, care coordination, and collaboration with adjusters to develop personalized plans. The position requires an active RN license, 3+ years of related experience, and preferred certifications in case