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MDD Forensic Accountants logo
MDD Forensic Accountants

Making Numbers Make Sense

RN Telephonic Nurse Case Manager

ManagerManagerOtherRemoteSeniorTeam 201-500Since 1933H1B No SponsorCompany SiteLinkedIn

Location

Alabama

Posted

112 days ago

Salary

$80K - $85K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

RN Telephonic Nurse Case Manager

MDD Forensic Accountants

• Provide telephonic case management for Workers’ Compensation cases. • Assess medical appropriateness of treatment plans and coordinate services to optimize recovery and cost efficiency. • Develop, implement, and modify individualized case management care plans. • Perform ongoing clinical assessments and review medical records to ensure quality and timely care. • Identify and address barriers to recovery with proactive action planning. • Coordinate communication between injured workers, employers, providers, insurers, and other stakeholders. • Promote and document return-to-work capability at each medical milestone. • Ensure compliance with state-mandated treatment guidelines, nationally published protocols, and client requirements. • Track outcomes including patient satisfaction, return-to-work progress, and disability duration. • Utilize utilization review tools when indicated (pre-certification, concurrent review, retrospective review, medical director review). • Monitor provider and vendor performance to ensure quality and appropriate care delivery. • Maintain detailed and accurate documentation within the case management system. • Serve as a patient advocate while adhering to all legal, ethical, accreditation, and regulatory standards. • Participate in Quality Assurance, Grievance, or other committees as assigned. • Provide training or mentorship to claims staff or junior team members as appropriate. • Perform additional duties as assigned.

Job Requirements

  • Active, unrestricted RN license.
  • Minimum 3 years of clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial, ER, or occupational health).
  • Workers’ Compensation case management experience preferred.
  • Strong knowledge of treatment guidelines and utilization management principles.
  • Excellent verbal and written communication skills.
  • Ability to work independently in a remote environment.
  • Proficiency in computer systems and claims/case management software.
  • Telephonic case management experience.
  • Experience applying evidence-based disability duration guidelines.
  • Prior experience training or mentoring staff.

Benefits

  • Medical, dental, and vision plans to ensure your health and that of your family.
  • A 401k plan with employer matching to help you build a secure financial future.
  • Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
  • Paid holidays.
  • Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

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