Telephonic Medical Case Manager

Crawford & Company; California (MO); Remote; USD 60,000 - 100,000; Full time

Job summary

An innovative firm is seeking a Telephonic Medical Case Manager to provide exceptional case management services from the comfort of your home. This role emphasizes effective communication and collaboration with various stakeholders to ensure optimal patient outcomes. You will leverage your clinical expertise to assess medical data and guide treatment plans while meeting productivity and quality standards. Join a global team that values diversity and offers competitive pay, ongoing training, and a culture of respect. If you're passionate about making a difference in people's lives, this opportunity is for you!

Benefits

Free CEU’s for licenses and certificates

License and national certification reimbursement

Work from home

No travel involved

Qualifications

• 1-3 years clinical experience required; URAC-certified case management or RN license needed.
• Knowledge of case management practices and ability to analyze data for improvement.

Responsibilities

• Provide effective case management services and evaluate medical status.
• Communicate regularly with claims adjusters and facilitate return to work.

Skills

Case Management

Communication Skills

Organizational Skills

Analytical Skills

Education

Associate's Degree in Nursing

Bachelor of Science in Nursing (BSN)

Job description

Join to apply for the Telephonic Medical Case Manager role at Crawford & Company

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Join to apply for the Telephonic Medical Case Manager role at Crawford & Company

• Free CEU’s for licenses and certificates
• License and national certification reimbursement
• This is a work from home telephonic case management position!
• No Travel involved!
• RN, Compact licensure and an advanced Nurse case Management certification (ex: CCM, COHN, CRRN) are required!

Job Description

• Provide effective case management services in an appropriate, cost-effective manner.
• Deliver medical case management services consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines to patients/employees receiving benefits under various insurance lines.

Responsibilities

• Review case records, evaluate medical status, identify needs and obstacles, and provide proactive case management services.
• Offer opinions on case costs, treatment plans, outcomes, and facilitate RTW (Return to Work).
• Meet administrative, productivity, and QA standards with minimal supervision.
• Perform job site evaluations as needed.
• Establish professional relationships to facilitate timely RTW, coordinate with all involved parties.
• Communicate regularly with claims adjusters and other stakeholders.
• Obtain and review medical records, facilitate peer reviews and IMEs.
• Use clinical expertise to interpret medical data and provide assessments.
• Travel approximately 70% of work time to homes, healthcare providers, and job sites.
• Meet monthly production and QA requirements.
• Review cases with supervisors and uphold company standards and values.
• Demonstrate excellent customer service and problem-solving skills.
• Perform other duties as assigned.

Qualifications

• Associate's degree or relevant nursing certification; BSN preferred.
• 1-3 years clinical experience; URAC-certified case management or RN license required.
• Knowledge of case management practices, excellent communication, organizational, and computer skills.
• Ability to build collaborative relationships and analyze data for process improvement.
• Active RN license in good standing; willingness to obtain additional certifications within 36 months.
• Must be fully vaccinated against COVID-19 if required by law.
• Travel approximately 70% of the time; valid driver’s license required.

About Us

Why Crawford? Because a claim is more than a number — it’s a person. We help restore lives and communities. Join us to grow, innovate, and be part of a global team that values diversity and inclusion.

We offer competitive pay, benefits, ongoing training, and a culture of respect and collaboration.

Crawford & Company is an Equal Opportunity Employer and participates in E-Verify.