Remote Case Manager (RN)

Position Overview Under the direction of the Director of Injury Management, the Case Manager administers the intake of calls from contracted clients, injured workers, Workers' Compensation Insurance adjusters, medical providers, and clinic staff. They provide exceptional service and quality treatment options to the patient and client throughout the injury management life‑cycle. Principal Duties and Responsibilities (Essential Functions) Triage injury/illness calls to determine if emergent or non‑emergent. Determine if injury/illness requires immediate treatment or first‑aid advice. Research and locate the nearest facility for injury. Contact medical facilities to determine availability of adequate services; coordinate visits via phone/fax. Speak with medical personnel regarding mechanism of injury/illness and discuss appropriate treatment pathways, obtaining UDS and BAT when applicable, and workplace accommodation availability. Inform client/injured worker of name/location and contact information of medical facility available. Notify appropriate contacts via email of injury/illness details with initial information within one hour of notification, unless an extreme situation. Provide updates of diagnosis, work status, plan of care and follow‑up appointments to appropriate personnel with injured worker’s employer and adjuster. Provide updates, diagnosis, clinic notes and treatment authorization requests to designated representative for client and Worker’s Compensation insurance adjuster. Log injury/illness details on spreadsheet; client specific. Enter injured worker, adjuster name and claim number into billing portal to apply billing time and status of case as it occurs. Bill time for each case according to services rendered. Field Case Management services for client/injured worker needing onsite Case Management services at the time of visit. This includes communicating directly with the provider and obtaining pertinent paperwork at the visit. Generate letters to providers for clarification of work‑relatedness and/or treatment plan. Obtain and review medical records and diagnostics with relation to present injury/illness, prior history and/or forward to specialty providers when allocated. Properly document phone calls made and received, interpretation of medical records from each exam, work status, and all emails transpired with regard to each case. Coordinate SMOs with specialists as needed. Coordinate FCEs to determine job capabilities. Rotate call to ensure 24/7/365 CM services; perform duties as stated above for calls received. Transfer phone lines every morning and evening for phone coverage 24 hrs a day. Assist upper management in CM activities as requested. Answer phones in a professional manner when receptionist is not available. Attend and participate in staff meetings. Assist in office related tasks as needed. Participate in opportunities for learning and skill maintenance/development, including internal and external training and workshops. Other duties assigned by the supervisors. Education High School Diploma or GED required and completion of a vocational program leading to a nursing license. Licensures / Certification Must possess and retain a valid RN license for the state of LA (or compact multi‑state license). Obtain a CWCP certification within two (2) years of employment. Experience Minimum two (2) years of nursing experience in a clinical setting, or previous occupational health experience. ER, ICU or PACU experience preferred. Schedule Monday – Friday 8:30 a.m. – 5:00 p.m., CST. This position is remote but may require in‑office training as necessary. Some at‑home, on‑call work on a rotating basis is also required. Training Training for this position will be held primarily remotely, but may require in‑office training at our corporate office depending on demands of training. Important Notice Please attach all licensures, certifications, education, and documentation to the upload portion of the application. Equal Opportunity Employment CORE, CHN, and our subsidiaries are Equal Opportunity Employers. EOE/ADAAA/AA. Accessibility: If you need an accommodation as part of the employment process please contact Human Resources at Phone: View phone number on click.appcast.io Email: View email address on click.appcast.io Equal Opportunity Employer, including individuals with disabilities and veterans. Know Your Rights: Workplace Discrimination is Illegal poster – EEO poster – EPPA poster – #J-18808-Ljbffr