RN Case Manager

Sheakley; Columbus (OH); On-site; USD 60,000 - 85,000; Full time

Job summary

Sheakley is seeking a Case Manager in Ohio to serve as the primary clinical contact for injured workers, coordinating care and facilitating timely return-to-work outcomes. This role requires strong clinical judgment and collaboration with medical providers, employers, and insurers.

The position emphasizes assessment of treatment plans, communicating across parties, maintaining confidentiality, and upholding professional standards. Travel for employer meetings may be required.

Qualifications

• Current, unrestricted Ohio licensure or certification allowing independent assessment within scope of practice
• Eligible to hold multi-state licenses as needed
• Two years of direct clinical care experience (full-time equivalent)
• Preference for at least one year of active case management in worker's compensation
• Continuing education required to maintain licensure and certification

Responsibilities

• Reports directly to the Case Management Team Lead
• First post-injury contact after triage; develop and manage return-to-work opportunities with injured workers, providers, and employer contacts
• Assess appropriateness of level of care, diagnostic tests, and clinical procedures for utilization review concurrently
• Coordinate with Utilization Review on treatment plans and vocational rehab until completion
• Assess quality and clinical risk issues; report to Team Lead
• Review medical records for completeness
• Gather and interpret information for assessment, treatment, and patient care
• Develop, implement and monitor plan of care
• Communicate with injured worker, employer, provider, BWC, and TPA (five-point contact)
• Provide education/guidance to all parties, including claim reviews and direction to five-point contact
• Foster positive team atmosphere and collaborate within the team
• Demonstrate problem identification and resolution for sound decision making
• Maintain confidentiality
• Work independently and manage priorities
• Uphold UniComp values: urgency, optimism, independence, respect for dignity
• Perform other duties as assigned
• Practice nursing within Ohio Board of Nursing Scope of Practice
• Travel to employer meetings or offsite functions as needed

Skills

Leadership

Communication

Organizational skills

Decision making

Education

Ohio licensure or certification

Multi-state license eligibility

Direct clinical care experience (2 years)

Case management in workers' compensation (1+ year)

Continuing education to maintain licensure

Job description

Job Summary:The Case Manager serves as the primary clinical contact for injured workers, coordinating care and facilitating safe, timely return-to-work outcomes. This role involves assessing treatment plans, collaborating with medical providers, employers, and insurers, and ensuring quality, compliance, and effective communication across all parties. The Case Manager must exercise strong clinical judgment, organizational skills, and maintain confidentiality.

QUALIFICATIONS:

• A current, unrestricted Ohio state licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline
• Eligibility to hold a multi-state licenses as needed to meet the needs of the company
• Two years full-time equivalent of direct clinical care to the consumer and
• Prefer a minimum of one (1) year of active case management experience in worker's compensation
• Maintains continuing education as required to maintain licensure and certification
• Excellent leadership, verbal/written communication skills, strong organizational skills, and excellent decision making and judgment

ROLE AND RESPONSIBILITIES FOR THE CASE MANAGER:

• Reports directly to The Case Management Team Lead
• Serve as the first point of post-injury contact after triage, developing and managing return to work opportunities with injured workers, designated network providers, and employer contacts
• Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis
• Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion
• Assess quality and clinical risk issues on a concurrent basis; report any recognized issue to the Case Management Team Lead
• Assess documentation of medical records for completeness on a concurrent basis
• Ability to obtain and interpret information appropriate to injured workers' needs as required for assessment, treatment, and patient care services
• Assess, develop, implement and monitor plan of care;
• Initiate communication and consistently communicate with the injured worker, employer, provider, BWC, and TPA (five-point contact, which could include attorney for IW/employer)
• Provide education and guidance to all parties to the claim; this includes: claim review at staffings, and/or providing direction to any member of the five-point contact
• Develop and maintain a positive work atmosphere and support overall team; demonstrate ability to work within a team structure
• Practice capable and effective problem identification and resolution skills as a method of sound decision making
• Maintain confidentiality
• Work independently, efficiently, and deal with priorities
• Understand and uphold UniComp philosophy and demonstrate commitment to UniComp's core values: have a sense of urgency, be optimistic, promote independence, and respect human dignity
• Perform other duties as assigned
• Practice nursing within the Scope of Practice as designated by the State of Ohio Board of Nursing
• Employee may be asked to travel from time to time to attend employer meetings or other offsite functions.