Nurse Case Manager

As a Nurse Case Manager, you will:

• →Conduct comprehensive initial and ongoing assessments of injured workers' medical conditions, treatment plans, clinical histories, and functional limitations.
• →Develop and implement medical management strategies that support recovery and resolution of workers' compensation claims.
• →Coordinate care with healthcare providers, vendors, and claims adjusters to ensure appropriate, evidence-based treatment plans.
• →Review treatment recommendations against workers' compensation guidelines and utilization review standards to ensure medical necessity and cost efficiency.
• →Facilitate communication among injured workers, medical providers, claims professionals, and other stakeholders regarding treatment progress, prognosis, and work capabilities.
• →Evaluate job descriptions and identify modified duty or transitional work opportunities that align with medical restrictions.
• →Assist employers with return-to-work planning and accommodation strategies.
• →Maintain accurate, timely documentation of case activity, medical records, communications, and treatment milestones.
• →Travel to customer locations to educate clients on Great West's nurse case management services and build strong working relationships.
• →Provide medical and disability management guidance to claims professionals through training, mentoring, and consultation.
• →Assist with the coordination and management of medical vendors and cost containment resources.
• →Stay informed on workers' compensation laws, regulations, medical case management best practices, and industry developments.
• →Maintain required licenses, certifications, and continuing education requirements.

We're seeking a professional who:

• Has a passion for helping injured workers achieve positive recovery outcomes.
• Demonstrates strong clinical assessment and critical thinking skills.
• Excels at communication, relationship building, and collaboration.
• Can effectively manage multiple cases and priorities in a fast-paced environment.
• Is comfortable working independently while also contributing to a team-oriented culture.
• Possesses strong organizational and documentation skills.
• Is committed to exceptional customer service and professional integrity.

• Graduate of an accredited School of Nursing required.
• Bachelor of Science in Nursing (BSN) preferred.
• Active, unrestricted Registered Nurse (RN) compact license required.
• Minimum of 5-7 years of clinical nursing experience required. Experience in Occupational Health, Emergency Room (ER), Intensive Care Unit (ICU), Orthopedics, Rehabilitation, or similar clinical settings preferred.
• Prior workers' compensation case management experience highly desirable.
• Certified Case Manager (CCM) designation preferred and required to be obtained within two years of hire.
• Ability to travel periodically to customer locations.