What are the responsibilities and job description for the Registered Nurse Case Manager - Workers' Compensation position at Managed Care Network, Inc.?
Company Overview
Managed Care Network, Inc. is an established managed care company who strives to be the best employer in the Property & Casualty marketplace by living our values and by providing a work environment that employees can be proud of. Through our company values, we promote employee growth so each person can Thrive and are appreciated for the expertise, hard work, and passion they bring to the company. We provide unique solutions quickly to solve problems and make our customers’ jobs easier.
About the Role
We are seeking an experienced and compassionate Nurse Case Manager(s) to support injured workers through the workers’ compensation process. This role involves coordinating medical care, assisting in return-to-work planning, evaluating treatment plans, and working closely with physicians and employers.
Key Responsibilities
Case Coordination
- Review all medical and supplemental documentation upon assignment.
- Coordinate hospital discharge planning, transitions to rehabilitation facilities, and home based care.
- Arrange medically necessary transportation and durable medical equipment.
- Facilitate prescription medication authorization and utilization review.
Claimant Support & Communication
- Communicate regularly with claimants, providers and employers.
- Develop individualized medical treatment plans tailored to the claimant’s condition and recovery goals.
- Conduct home visits, hospital visits, and rehabilitation facility assessments as needed.
Clinical Evaluation
- Assess treatment plans for medical necessity, appropriateness, and cost effectiveness.
- Evaluate claimant progress, barriers to recovery, and return to work readiness.
- Research and coordinate community resources for chronic or catastrophic conditions.
Reporting & Documentation
- Prepare narrative reports documenting activities, outcomes, and recommendations.
- Ensure all documentation is accurate, timely, and compliant with New York State Workers’ Compensation Law.
Return-to-Work Support
- Collaborate with employers to review job requirements, potential modifications, and transitional duty options.
- Discuss return to work goals with claimants and obtain attorney approval when required.
Qualifications
Education & Experience
- Current RN license.
- Minimum 2 years of nurse case management experience in workers’ compensation or a related field.
Required Certifications (must have at least one):
- Certified Disability Management Specialist (CDMS)
- Certified Case Manager (CCM)
- Certified Rehabilitation Registered Nurse (CRRN)
- Case Manager–Certified (CMC)
- Certified Occupational Health Nurse (COHN or COHN S)
Knowledge & Skills
- Understanding of New York State Workers’ Compensation.
- Experience communicating with multidisciplinary teams including physicians, therapists, employers, and legal representatives.
- Excellent written communication and documentation skills.
- Ability to travel for claimant visits when required.
Job Type: Full-time
Pay: $75,000.00 - $90,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: Remote
Salary : $75,000 - $90,000