Telephonic Case Manager

Appone; Atlanta (GA); Remote; USD 88,000 - 140,000; Full time

Benefits offered by this job

Bonus potential

Flexible schedule

Medical, dental, vision insurance

Retirement plan

Job summary

ISYS Case Management seeks a Telephonic Case Manager—RN with active licensure and CMSA-aligned experience in workers’ compensation. This remote role supports injured workers, coordinating care, documenting progress, and communicating with insurance carriers and providers from Atlanta and surrounding areas.

The position offers strong earning potential, annual bonus opportunities, and flexible scheduling, with benefits including medical, dental, and retirement plans. Must reside in Atlanta area.

Qualifications

• High School Diploma required.
• RN-BC certification required.
• CCM certification preferred/after first year for certain roles.
• Excellent English communication skills required.
• Proficient PC and MS Office skills required.

Responsibilities

• Provide telephonic case management within workers' compensation.
• Coordinate care and communicate with insurers, providers, and attorneys.
• Assist with documentation and return-to-work processes.
• Manage caseload with proactive time management and prioritization.
• Engage in virtual attendance at telemedicine appointments.

Skills

English proficiency

Communication

PC skills

Time management

Customer service

Detail-oriented

Education

High School Diploma

RN-BC

CCM certification

Tools

MS Office Suite

Job description

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Position Requirements

REQUIREMENTS

• High School Diploma
• Current valid State Driver’s license and car insurance (insurance limits of 250/500)
• Registered Nurse (RN-BC)
• Outstanding English language skills: speaking, writing, grammar, professional communication
• Proficient working with PCs and Windows and MS Office Suite (ability to type/key at a moderate speed) and learn new technologies
• Excellent prioritization, problem solving, organization and time management
• Strong character: Dependability, Honesty, Determination and Compassion
• Obtain CCM certification after the first year of employment (applies to Case Managers who began employment as of March 2019 and all Case Managers in Texas)
• Ability and willingness to establish home office with strong internet connection
• Understanding and appreciation of excellent customer service and a desire to serve
• All credentials and licensure must be valid and maintained

NOT REQUIRED BUT PREFERRED

• Bachelor’s Degree or Higher Education
• Related Certifications: CCM, CDMS, ACM, LCSW and/or CRC*
• Background in Nursing, Social Work, Counseling, Occupational Health, Psychology, and/or Chiropractic.

Applicants notice

Our Human Resources emails come only from email addresses ending in @isyscm.com. Do not respond to or share personal information with anyone claiming to represent ISYS from another email domain.

Full-Time/Part-Time Full-Time

About the Organization

Telephonic Case Manager - RN (remote, professional/business, non-clinical, must reside in Atlanta or surrounding areas)

Feel the Value of Excellence by providing quality medical case management for injured workers, coordinating appropriate care, making recommendations, and professionally communicating with insurance carriers, healthcare providers, ancillary vendors, employers, and attorneys. Make a difference by driving to and attending medical appointments in-person. Complete prompt and thorough documentation and qualify for bonus compensation. Enjoy inserting your own style into the work you do and benefiting from more flexibility at work. This position offers the privilege to impact your earnings and the opportunity to adjust your schedule. Do you have a strong work ethic and high integrity? Then this very rewarding and autonomous role might just be the right fit!

COMPENSATION RANGE

$88,000.00 to $140,000.00 annually

GENERAL SUMMARY

Provide telephonic case management services (within the worker’s compensation industry) by utilizing professional judgment and discretion, applying professional processes, and by using professional expertise to guide complex decision making in alignment with ISYS, customer, and Case Management Society of America (CMSA) expectations.

Facilitate appropriate qualitative and timely medical care for injured workers by implementing prudent case management strategies, making appropriate recommendations to advance case progression, demonstrating proactive communication, and appropriate coordination with all parties to enable optimal recovery outcomes, including return to work determination, file progression towards Permanent and Stationary designation, and cost containment for the customer.

Facilitate timely claim resolution through proactive and professional communications, conducting case specific research, information analysis and providing appropriate advice, direction, and action plans to implement treatment and optimize realistic outcomes. This position differs from Case Manager, as primary case management duties are carried out telephonically with minimal field-based case management activity.

ESSENTIAL JOB FUNCTIONS

• Telephonic management of cases as assigned by ISYS, including “rush”/same day referrals from ISYS’ customers and attendance at medical appointments scheduled during the hours of the facilities providing treatment.

• Autonomous management of assigned caseload, including coordination of weekly and daily work activities and schedule, ensuring optimal time management and professional prioritization of all activities.

• Providing virtual case management services via videoconferences, teleconferences, and telephonic communications following the CMSA guidelines and ISYS protocols and procedures.

• Enthusiastically and professionally coordinate, facilitate, conduct, and complete virtual attendance at telemedicine appointments, with physicians, other medical professionals and ancillary providers in order to facilitate treatment recommendations in a timely manner.

• Initiate and conduct professional discussions with medical providers regarding diagnosis, treatment, and prognosis.

• Apply the case management process, education, and experience to facilitate appropriate and timely treatment and recovery of the injured worker with the goal of maximal recovery and maximal return to work.

• Provide proactive and timely communication, and coordinate collaboration with all parties involved in each case, by phone, and/or in writing.

• Support the injured worker’s progress towards achieving Maximum Medical Improvement and foster realistic and effective Return to Work opportunities by exploring viable options with all involved parties.

• Influence and collaborate with physicians by providing professional case management opinions and recommendations in order to proactively move cases towards Maximum Medical Improvement and provide cost containment for customers.

• Make recommendations to Claims Professionals/customers in order to ensure the best interests of the injured worker and claims progression, and ensuring the customer is informed of various potential outcomes and potential costs.

• Provide timely written and verbal communication of the employee’s medical status and treatment plan to the Claims Professional and other parties, as necessary, appropriate, and authorized.

• Create effective action plans for customer approval and implement the plan in order to enhance case outcomes and reduce complications, evaluate the success or failure of such plans, and modify plans as necessary to achieve effective and qualitative outcomes.

• Consider customer cost containment in all scenarios and recommendations.

• Keep in mind potential liability in all actions and make recommendations based on sound professional judgment and nursing/medical knowledge.

• A big picture perspective always. Keep in mind the agendas of the various parties and ensure that the case is progressing.

• Provide timely written and verbal communication of the injured workers’ abilities and restrictions to the Employer for coordination of return to work.

GREAT BENEFITS

The ability to impact your own income through conscious effort is such a rare privilege and is one of the main perks of this special position. Compensation includes both biweekly salary and bonus. Ongoing bonus pay is not capped which means high earning potential is in your hands.

The opportunity to adjust your work schedule and navigate your responsibilities in a way that fits your personal preference and workstyle.

Rest and relaxation are important, so PTO (vacation) is accrued monthly. Plus, you can earn bonus PTO rewards annually and enjoy even more time off.

A benefits package with tax-deferred retirement program, a flexible schedule, medical, dental, and vision insurance, ancillary supplement health plans, Long-term disability insurance, and employee assistance program.

ABOUT ISYS CASE MANAGEMENT

ISYS is an organization of people with big minds, big hearts, lots of spirit and good character whose mission is to work creatively and intensively to provide case management solutions and have a positive impact on those we serve. Providing forward focused care coordination and customer service in the workers compensation community since 1998, ISYS has an established brand reputation of delivering on our promise to provide consistent high quality catastrophic, rush, and onsite field medical case management services. Our company culture is based on living our values to:

Always do the right thing

Deliver excellence in everything we do

Encourage a Hug Your Customer philosophy

Communicate respectfully and proactively

Build relationships upon trust

Give generously

Pursue growth and learning

Be honest, authentic, grateful, and humble

Promote individual and economic liberty

Embrace the family spirit

Annual employee surveys are conducted as part of holding ourselves accountable to living these values and delivering on our promise to our employees. Annual team building, annual gatherings to acknowledge exceptional performance, and routine hugging are all part of our work family culture.

ISYS also has a Charitable Activities Committee that oversees and promotes employee involvement in our Pay it Forward program, which focuses on different ways to give back to the communities in which we live and work.

Thank you for your interest in working with ISYS!

Find employee testimonials and check us out at www.isyscm.com

For more information about our Privacy Practices please see our company website privacy policy at https://isyscm.com/isys-solutions-inc-california-privacy-notice-job-applicants/

This position is currently accepting applications.