Telephonic Workers' Compensation Nurse Case Manager (RN)

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

Job summary

CNA Insurance in Downers Grove, IL is seeking a Telephonic Nurse Case Manager to manage medical and disability case management within the Workers' Compensation claims department. This role partners with healthcare providers, employers and claim professionals to support timely decisions and return-to-work outcomes.

It operates on a hybrid schedule with two days in the office each week, and requires strong clinical judgment and communication skills to coordinate care and drive outcomes.

Qualifications

• 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.

Responsibilities

• Assesses disability status, makes recommendations and identifies appropriate resources.
• Gather and coordinate medical evidence for evaluation of functionality and disability duration.
• Consults on case management issues and applies effective interventions.
• Collaborates with medical providers to ensure appropriate treatment and return to work.
• Facilitates job modifications and educates involved parties regarding claims process and functionality relative to job requirements.
• Addresses causality and refers to appropriate medical expertise.
• Documents according to jurisdictional, departmental and accreditation requirements.

Skills

Case management

Medical terminology

Insurance industry knowledge

Professional judgment

Communication

Interpersonal skills

Organizational skills

Analytical skills

Microsoft Office

Independent work

Education

RN licensure

BSN preferred

CCM credential preferred

Tools

Microsoft Office

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.

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.

CNA utilizes AI-enabled technology during the recruiting process. For more information, please visit our 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]