Telephonic Medical Case Manager – Workers' Comp & RTW

TRISTAR Insurance Group; United States; On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k)

Paid Holidays

Paid Time Off

Referral Bonus

Job summary

TRISTAR Insurance Group seeks a Medical Case Manager to perform telephonic case management in a workers' compensation setting, coordinating resources and cost-effective options to support individualized treatment goals and return-to-work placements.

Qualifications include an RN license, CCM/CPDM/COHN/CDMS preferred, and 3+ years in managed care or workers' compensation. Strong communication and organizational skills are essential.

Qualifications

• RN license required or in process
• CCM, CPDM, COHN or CDMS certification preferred
• 3+ years of diverse clinical experience in managed care and workers' compensation environments

Responsibilities

• Provide telephonic outreach for assessment and coordination of care
• Conduct initial assessments with injured workers, employers and providers
• Coordinate contact with providers, claimants, RTW contacts and claims examiner
• Review case records, analyze data and define needs for proactive case management
• Facilitate timely return-to-work by coordinating with claimant, employer and physicians
• Maintain confidentiality in line with HIPAA/PHI rules

Skills

RN license

CCM

CPDM

COHN

CDMS

Managed care

Workers' comp

Communication

Microsoft Office

Bilingual

Education

Diploma/Associate/Bachelor in Nursing

Tools

EMR systems

Job description

TRISTAR Insurance Group seeks a Medical Case Manager to perform telephonic case management in a workers' compensation setting, coordinating resources and cost-effective options to support individualized treatment goals and return-to-work placements.

Qualifications include an RN license, CCM/CPDM/COHN/CDMS preferred, and 3+ years in managed care or workers' compensation. Strong communication and organizational skills are essential.