Nurse Case Manager

Nurse Case Manager page is loaded## Nurse Case Manager locations:
Lake Mary, FLtime type:
Full time posted on:
Posted Todayjob requisition :
R2624248

Medical Case Manager - CT08GE
We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.
As Nurse Case Manager, we seek to improve on our patients’ abilities! This position is part of a dynamic, fast-paced team of experienced Nurse Case Manager located remotely across the United States. The ideal candidate for the Nurse Case Manager role will oversee Workers’ Compensation claims with complex medical conditions referred for medical assessment, clarification of limitations/restrictions or case management. On average, a Nurse Case Manager shall handle 50-60 cases with a moderate degree of complexity and acuity of medical condition.

This individual will have the opportunity to collaborate with claims staff, the injured worker, an employer, and other healthcare professionals to promote quality medical care with a focus on returning our patients back to work. Our goal is to achieve optimum, cost-effective medical and vocational outcomes.
** Responsibilities include but are not limited to:
*** Through the use of clinical tools, telephonic interviews, and clinical information/data, completes assessments that will take into account information from various sources to address all conditions including biopsychosocial, co-morbid and multiple diagnoses that impact recovery and return to work.
* Leverages critical thinking, extensive clinical knowledge, experience, and skills in a collaborative process to develop a comprehensive strategy for the injured worker to become medically stable and/or return to work.
* Independently identifies complex situations where communication with internal and/or external partners is needed to reach a full understanding of the factors involved with the assessment of the mechanism of injury, causality, and ability to return to work.
* Application, Interpretation and Compliance with clinical criteria and guidelines, applicable policies and procedures, regulatory standards, and jurisdictional guidelines to determine eligibility and integration with available internal/external resources and programs.
* Using holistic approach to focus on medical and ability management activities resulting in accurate and timely treatment and return to work.
* Consults with supervisor and others to address and problem solve barriers to meeting goals and objectives, participate in round tables and claim meetings with claim partners to focus and benefit overall claim management.
*
* Qualifications:

*** RN with current unrestricted state licensure required.
* Associate degree in Nursing required.
* 3 years clinical practice experience required.
* Bachelor’s degree in nursing preferred, but not required.
* Certification as a CCM (CDMS, CRC, CVE and/or current CRRN), or willingness to pursue.
* Workers Compensation case management experience preferred.
** Key

Competencies:

*** Basic Computer proficiency (Microsoft Office Products including Word, Outlook, Excel, Power Point); which includes navigating multiple systems.
* Ability to effectively communicate telephonically and in written form.
* Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
* Work requires the ability to perform close inspection of handwritten and computer-generated documents as well as a PC monitor.
* Ability to synthesize large volumes of medical records & facilitate multi-point care coordination.
* Must meet productivity & quality expectations.
* Ability to organize and prioritize daily work independently and effectively.
** Additional

Competencies:

*** Strategic thinking
* Customer focus
* Business knowledge
* Problem solving
* Collaboration – partnership
* Decision making skills
* Communication skills
** Additional Information:
**
* Start Date:

April 27, 2026
* This role can have a Hybrid or Remote…