Nurse Case Manager/Operations

Job Description

Job Description

Benefits:

• Bonus based on performance
• Flexible schedule

Job DescriptionOperations & Clinical Services Manager (RN)

Forthright Case Management

Position Summary

Forthright Case Management is seeking a dynamic, highly organized, and relationship-focused Registered Nurse (RN) to serve in a dual Operations & Clinical Services role. This position is designed for an experienced nurse who can successfully balance operational leadership, client relations, business development, and administrative responsibilities while maintaining the ability to actively manage a nurse case management caseload as business needs require.

The ideal candidate is a licensed RN with experience in workers' compensation, medical case management, utilization management, occupational health, or catastrophic injury management. They should possess excellent clinical judgment, strong communication skills, and the ability to transition seamlessly between direct case management and operational leadership.

This individual will support Forthright's continued growth by overseeing daily operations, strengthening client relationships, assisting with referral management, supporting recruiting and onboarding, and providing high-quality nurse case management services.

Primary Responsibilities

Clinical Nurse Case Management

• Manage a caseload of workers' compensation nurse case management files when assigned.

• Coordinate medical treatment plans with injured workers, physicians, employers, adjusters, attorneys, and rehabilitation professionals.

• Attend physician appointments when appropriate.

• Evaluate treatment plans and identify barriers to recovery.

• Facilitate timely return-to-work planning.

• Prepare comprehensive case management reports that meet client expectations.

• Maintain documentation in accordance with state regulations, HIPAA, and client requirements.

• Provide telephonic and field case management services as needed.

• Serve as clinical backup for other Nurse Case Managers during vacations, leave, or increased caseloads.

Operations & Client Services

• Oversee daily administrative and operational workflows.

• Coordinate new referrals and assign cases appropriately.

• Monitor case progression and reporting deadlines.

• Ensure exceptional client service and timely communication with referral sources.

• Develop and maintain strong relationships with insurance carriers, TPAs, employers, attorneys, and healthcare providers.

• Support billing, operational reporting, and quality assurance initiatives.

• Identify opportunities to improve efficiency and clinical outcomes.

Business Development & Growth

• Represent Forthright Case Management at industry conferences, networking events, and client meetings.

• Assist with business development initiatives and relationship management.

• Support marketing efforts, including professional social media engagement and educational content.

• Strengthen existing client relationships while helping cultivate new referral sources.

Recruiting & Leadership

• Assist with recruiting, interviewing, onboarding, and mentoring Nurse Case Managers.

• Support clinical orientation and ongoing professional development.

• Assist leadership with policy implementation and operational improvements.

• Promote Forthright's culture of collaboration, professionalism, and clinical excellence.

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license.

• Minimum of 3 years of Nurse Case Management experience preferred.

• Experience in workers' compensation case management strongly preferred.

• Certified Case Manager (CCM) or willingness to obtain certification preferred.

• Excellent written and verbal communication skills.

• Strong clinical assessment and critical thinking abilities.

• Experience with Microsoft Office and electronic case management systems.

• Ability to travel locally for field case management and client meetings as needed.

Ideal Candidate

The successful candidate is someone who can comfortably transition between leadership and direct patient advocacy. One day may involve overseeing operations, developing client relationships, and supporting staff, while another may require managing complex catastrophic cases, attending physician appointments, or assisting an injured worker through recovery.

This individual is a compassionate nurse, an organized administrator, a confident communicator, and a proactive leader who is committed to delivering exceptional outcomes for clients and injured workers alike.

Why Join Forthright Case Management?

At Forthright Case Management, we believe excellent clinical care and exceptional client service go hand in hand. This unique hybrid position offers the opportunity to remain clinically engaged while helping shape the operational growth of an expanding organization. If you are looking for a leadership opportunity that combines nursing expertise with business operations and relationship management, we encourage you to apply.