Senior Nurse Case Manager: Field & Claims Leader

Blue Cross Blue Shield of Michigan; United States; Hybrid; USD 74,000 - 123,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a Senior Nurse Case Manager (SNCM) within the Claims Department. You will review complex workers’ compensation claims, assess medical necessity, and facilitate return to work.

This role may be telephonic or field-based, supporting on-site care coordination and program implementation. The SNCM leads in cost containment initiatives, mentors junior staff, and collaborates with physicians and employers to ensure timely, appropriate care and optimal

Qualifications

• Active RN license required.
• BSN preferred.
• Five years field/injury case management experience.

Responsibilities

• Oversee new assignments and make timely initial contacts with all parties.
• Review patient status and history to determine causal relation of symptoms to work injuries.
• Negotiate and coordinate with employer for early return to work and/or alternative duty.

Skills

Nurse Case Management

Negotiation

Communication

Independent Work

Problem Solving

Education

RN License

BSN preferred

Tools

Microsoft Windows Suite

Job description

Blue Cross Blue Shield of Michigan is seeking a Senior Nurse Case Manager (SNCM) within the Claims Department. You will review complex workers’ compensation claims, assess medical necessity, and facilitate return to work.

This role may be telephonic or field-based, supporting on-site care coordination and program implementation. The SNCM leads in cost containment initiatives, mentors junior staff, and collaborates with physicians and employers to ensure timely, appropriate care and optimal