Telephonic Case Manager

Crawford & Company; United States; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Remote work

Competitive pay based on experience

Quarterly bonuses

Free CEUs

License/certification reimbursement

Excellent work-life balance

Job summary

Crawford & Company is seeking an experienced RN Telephonic Case Manager to work remotely providing case management services for patients and employees. You will navigate their healthcare journeys, align with URAC standards, CMSA Standards of Practice, and Broadspire QA guidelines to promote quality care and cost-effective outcomes.

Ideal candidates hold an active multi-state RN license, reside in a compact state, with 1–3 years of clinical experience and national certifications such as CCM, CRC,

Qualifications

• Associate degree or nursing certification; BSN preferred.
• 1–3 years diverse clinical experience.
• RN license in good standing in home state.
• URAC/CDMS/CRRN/COHN certifications preferred; plan to test within 36 months.

Responsibilities

• Provide telephonic case management following URAC and CMSA standards.
• Navigate patients' healthcare journeys with quality and cost effectiveness.
• Collaborate with employers, adjusters, and clinicians to resolve cases.

Skills

Active RN license

Multi-state license

Compact state resident

URAC certification ready

Workers' compensation knowledge

Education

Associate degree in Nursing

BSN preferred

Tools

Microsoft Office

Lotus Notes

Job description

Remote RN Telephonic Case Manager Opportunity

We're seeking a compassionate and experienced RN Telephonic Case Manager to join our growing team.

Benefits

• 100% Remote Work Environment
• Competitive Compensation Based on Experience
• Quarterly Performance Bonuses
• Free CEUs for Ongoing Professional Development
• License and Certification Reimbursement
• Excellent Work-Life Balance

Qualifications

• Active Multi-State RN License
• Must reside in a Compact State
• National Certifications preferred: CCM, CRC, COHN, or CRRC
• Workers' Compensation Case Management experience is highly valued

What You'll Do

You’ll provide impactful case management services that help patients and employees navigate their healthcare journey. Working within URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines, you’ll ensure quality care while promoting positive outcomes and cost-effective solutions.

Requirements and Responsibilities

• Associate’s degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.
• Minimum of 1-3 years diverse clinical experience and one of the below:
• Certification as a case manager from the URAC-approved list of certifications (preferred);
• A registered nurse (RN) license.
• Must be compliant with state requirements regarding national certifications.
• General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
• Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
• Excellent analytical and customer service skills to facilitate the resolution of case management problems.
• Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.
• Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.
• Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes.
• Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously.
• Demonstrated leadership ability with a basic understanding of supervisory and management principles.
• Active RN home state licensure in good standing without restrictions with the State Board of Nursing.
• Must meet specific requirements to provide medical case management services.
• Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months.
• National certification must be obtained in order to reach Senior Medical Case Management status.