Field Case Manager Remote Full-Time San Diego, CA

Charles Taylor is a global provider of professional services to the insurance industry. Guardian Managed Care Solutions, a division of Charles Taylor TPA, is a leading provider of workers’ compensation managed care and cost containment solutions. We are seeking a dynamic Field Case Manager to join our team. This is a full‑time role based in San Diego, CA, with flexibility to work remotely. Job Summary The Field Case Manager evaluates the medical and vocational needs of injured employees to facilitate rehabilitation and promote a timely return to work. The manager acts as a liaison among patients/families, employers, providers, adjusters, and attorneys involved in workers’ compensation claims. Essential Functions Obtains medical history and signed medical release forms for care coordination. Requests, obtains, and reviews medical records. Assesses and analyzes injured employee’s medical and vocational status. Develops a plan of care to facilitate timely return to work and coordinates with employers as needed. Interviews patients at physician offices, homes, and/or workplaces to provide ongoing case management services. Communicates in-person and by phone with patients, medical providers, adjusters, attorneys, and vendors. Schedules appointments for treatment plan implementation and follow‑up. Coordinates and monitors progress of vendor referrals, consultations, and therapeutic services. Ensures transportation and translation are available for medical appointments when appropriate. Accompanies employees during physician consultations when appropriate. Conducts conferences with specialists regarding course of care and treatment. Ensures physicians address all employee and employer concerns. Explains injury diagnosis, treatment instructions, and recommendations to employees. Provides ongoing monitoring, contact, support, and education to promote compliance and address issues. With adjuster approval, coordinates medical and rehabilitative care, including appointments, medications, surgeries, therapies, diagnostics, equipment, transportation, and translation. Maintains rapport with all professionals involved in rehabilitation to facilitate treatment and successful return to work. Documents case management services, employee progress, return‑to‑work status, maximum medical improvement, and significant events per company standards. Coordinates return‑to‑work issues with employers, including job site analysis and ergonomic evaluation, and presents findings to physicians. Keeps a working knowledge of up‑to‑date medical information and provides research to adjusters on medical necessity and appropriateness. Applies all applicable laws and regulations related to case management and rehabilitation in the assigned region. Substantiates case work or documentation by testifying when required. Completes time and expense reporting in a timely manner per company guidelines. Works closely with a team of case managers and support staff. Requirements Must hold at least one credential: CCM, CRRN, CDMS, COHN, or CRC. Must hold an unrestricted Registered Nurse license in California. Must maintain all applicable credentials, licensure, and/or certifications for case management in California. Must have a current, unrestricted driver’s license and proof of automobile insurance. Must be willing to travel day‑to‑day within the assigned region. Can work independently and within a team while managing multiple tasks simultaneously. Possesses strong professional communication, organizational, and interpersonal skills. Strong customer service orientation. Demonstrates critical thinking, judgement, and sound decision making with attention to detail. Computer literate with daily use of MS Office (Word, Excel, PowerPoint) and Teams. Proofreads typed material for grammatical, typographical, or spelling errors. Adapts to changing work activities while prioritizing projects. Knowledge of standard office equipment (computer, fax, copier, scanner, phone). Additional Experience (Preferred) Case management experience at a TPA, in the medical field, or workers' compensation industry. Knowledge of Longshore and Harbor Workers' Compensation Act and Jones Act claims. Knowledge of California Workers’ Compensation claims. Spanish language proficiency, both conversational and medical terminology. Salary and Benefits Salary range: $115,000-125,000. The role includes competitive benefits such as medical, dental, vision, life insurance and a 401(K) with match. Equal Opportunity Employer Charles Taylor is an inclusive employer. We provide an environment of mutual respect with zero tolerance for discrimination of any kind and promote a fair recruitment process. We welcome applicants of all ages, disabilities, gender identities, marital or family status, races, religions, sexes, and sexual orientations. About Charles Taylor Charles Taylor is an independent, global provider of claims solutions, insurance management services, and technology platforms for all property and casualty markets, including commercial property, workers’ compensation, and auto/liability. We offer third‑party administration and managed care programs with specialization in catastrophic, aviation, energy, and marine claims. #J-18808-Ljbffr Charles Taylor