Telephonic Workers' Compensation Nurse Case Manager (RN)

CNA Insurance; Downers Grove (IL); Hybrid; USD 54,000 - 103,000; Full time

Job summary

CNA Insurance is seeking a Telephonic Nurse Case Manager to join the Workers’ Compensation claims team. You will assess injured workers, apply evidence-based case management, and coordinate with providers, employers, claimants, and claims professionals to support timely decisions and return-to-work outcomes.

This hybrid role requires RN licensure (BSN preferred), CCM preferred, and typically five years of clinical experience with disability management.

Qualifications

• Strong knowledge of case management, specialty area, medical terminology and conditions, insurance industry as well as company policies and procedures.
• Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service.
• Experience with coordinating with providers and stakeholders in disability management.
• Two or more years disability management experience preferred.

Responsibilities

• Assess disability status and make recommendations with resources.
• Gather and coordinate medical evidence for functionality evaluations.
• Consult on case management issues and apply interventions.
• Collaborate with medical providers to ensure appropriate treatment and return to work.
• Facilitate job modifications and educate involved parties about claims process and functionality.
• Document according to jurisdictional and department guidelines.

Skills

Case management

Medical terminology

Analytical skills

Communication

Education

RN

BSN preferred

CCM preferred

Tools

Microsoft Office Suite

Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

The Telephonic Nurse Case Manager provides medical and disability case management services within the Workers’ Compensation claims department. Responsibilities include assessing injured worker needs, applying evidence-based case management principles, and collaborating with healthcare providers, employers, claimants, and claims professionals to support timely decision-making, appropriate treatment, and return-to-work outcomes.

This position works a hybrid work schedule of 2 days per week in office.

JOB DESCRIPTION:

Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:

• Assesses disability status, makes recommendations and identifies appropriate resources.
• Accountable for gathering and coordinating medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and assigns length of disability.
• Consults on case management issues in area of specialty and applies effective case management interventions.
• Collaborates with medical and other providers to ensure appropriate treatment and return to work.
• Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements while remaining externally focused.
• Addresses causality and refers to appropriate medical expertise.
• Documents according to jurisdictional, departmental and accreditation requirements.

Reporting Relationship
Typically Lead Specialty Nurse Case Manager

Skills, Knowledge and Abilities

• Strong knowledge of case management, specialty area, medical terminology and conditions, insurance industry as well as company policies and procedures.
• Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service.
• Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise and effective manner.
• Strong interpersonal skills with the ability to effectively interact with internal and external business partners.
• Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks.
• Knowledge of Microsoft Office Suite as well as other business related software.
• Ability to work independently.

Education and Experience

• Registered Nurse (RN), with BSN preferred.
• Certified Case Manager (CCM) credential preferred, or willingness to obtain case management certification.
• Typically a minimum five years related clinical experience, with two or more years disability management experience preferred.

#LI-KP1

#LI-Hybrid

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, please visit cnabenefits.com.

CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitour careers page.

CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [e-mail]