Telephonic RN Case Manager (Bilingual)

Elite Tek Services, Inc.; San Diego (CA); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare services provider is seeking a Clinical Services Manager – RN Telephonic Case Management based in San Diego. In this role, you will oversee case management services, collaborate with clients and physicians, and advocate for patients' treatment plans. This position requires strong clinical nursing credentials and the ability to work independently while delivering high-quality care.

Qualifications

• 2+ years clinical practice preferred, with workers’ compensation-related experience preferred.
• Current CA RN license, CA practice experience, or recent CA domicile required.
• Must be in good standing.

Responsibilities

• Ensure optimum recovery on every claim while establishing trust and providing education.
• Perform case direction to field case managers for on-site interventions.
• Independently manage workload, prioritizing and managing cases effectively.

Skills

Bilingual in English and Spanish

Advocacy skills

Organizational and planning skills

Communication skills

Basic computer skills (Excel, Word, Outlook)

Education

Associates Degree or Bachelor’s Degree in nursing or related field

Active Registered Nurse (RN) license

Professional certification in Case Management (CCM, CRC, CRRN, COHN)

Job description

Job Summary

As a Clinical Services Manager – RN Telephonic Case Management, you will ensure optimum recovery on every claim while establishing trust, providing education, delivering information, and care. You will provide case direction to field case managers when on-site intervention is required.

Primary Duties & Responsibilities

Performing within the professional practice guidelines set forth by the state Board of Nursing & Division of Workers’ Compensation. Collaborating with clients and business partners to ensure quality standards are maintained for all accounts. Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan. Interview injured persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational. Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient. Work with employers and physicians to modify job duties where practical to facilitate early return to work. Evaluate and modify case goals based on injured/disabled persons’ improvement and treatment effectiveness. Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.

Qualifications

Bilingual in English and SpanishREQUIRED Professional certification in Case Management (CCM, CRC, CRRN, COHN)REQUIRED. Current CA RN license/CA practice experience/CA domicile OR recent CA domicileREQUIRED. Associates Degree or Bachelor’s Degree in nursing or related field. Active Registered Nurse (RN) licenseREQUIRED. Must be in good standing. 2+ years clinical practice preferred. Workers’ compensation-related experience preferred. Have the ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills. Show organizational and planning skills.