A reputable managed care company that is transforming the way health care is accessed and delivered is currently seeking Workers' Compensation Nurse Case Managers. This is a fully remote role, where you will be tasked with collaborating with medical care providers, employers, and employees to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under their plan.
The base pay range for this position is $50 to $58 per hour. The actual compensation offered to the successful candidate may vary from posted hiring range based on geographic location, work experience, education, and/or skill level, among other things. Details about eligibility for bonus compensation (if applicable) will be finalized at the time of the offer. This is a true temp-to-perm role; you can gain access to company benefits, paid time off, and more perks once you transition!
Responsibilities:
- Collaborates with workers' compensation patients, employers, providers, and claims adjusters to coordinate medical and disability services for timely return to work.
- Provides utilization review, continued stay reviews, and utilization management based on clinical judgment and state guidelines.
- Knowledgeable and compliant with New York State Workers’ Compensation Law, Medical Treatment Guidelines, ERISA, HIPAA confidentiality requirements, and NY Formulary Review process.
- Proven ability to anticipate claimant's treatment or recovery milestones.
- Provides Case Management services, including assessing barriers to recovery and determining treatment alternatives.
- Facilitates and expedites discharge planning as needed.
- Produces accurate electronic records of individual cases.
- Ensures timely, cost-effective medical care for injured workers' recovery.
- Answers provider calls and assists with Casualty Department workload as necessary.
- Kind, caring, and positive with all customers and fellow employees.
- Adheres to established quality assurance standards and MagnaCare policies and procedures.
Requirements:
- Currently licensed Registered Nurse (RN) in New York State
- Bachelor's Degree preferred
- Minimum of 4 years experience in a clinical environment required
- Previous workers’ compensation case management experience required
- Candidate must currently live in NY, NJ, CT, FL