Nurse Case Manager

Ascendant Health is a Michigan-based nurse case management company. We help people recovering from serious personal injuries get the right care at the right time, coordinating between patients, providers, attorneys, and insurers so nothing falls through the cracks. Our work sits where clinical care meets advocacy, and our nurses are the reason patients move forward with confidence. We lead with our values: Patient First, Teamwork, Proactivity, Integrity and Accountability, and Growth. If you want your clinical leadership to have a direct, visible impact on patients and on the people you lead, you will feel at home here. The Opportunity The Case Manager (CM) is responsible for coordinating, managing, and advocating for patient care following personal injuries. The Case Manager serves as the primary liaison between patients, healthcare providers, attorneys, family members, and insurance carriers to ensure timely, appropriate, and patient-centered care while maintaining compliance. Primary Responsibilities Patient Care Coordination Serve as the primary point of contact for assigned patients throughout their recovery. Advocate for patient needs while supporting safe, appropriate, and timely care. Develop, implement, and adjust individualized plans of care based on diagnosis, provider recommendations, and patient progress. Ensure patients are scheduled with recommended specialties within established timelines (PMR/Pain within 30 days; all specialties within 60 days). Encourage patient engagement and compliance with treatment plans. Attend mandatory in-person appointments, including: All PMR/Pain Management; Orthopedics; Initial appointments for specialty providers Attend initial evaluations for therapy services (PT, OT, chiropractic, etc.). Attend additional appointments in person or via telehealth as appropriate. Confirm patient attendance and transportation prior to all appointments. Arrange appointment coverage when unable to attend. Submit POV forms and billing documentation within 24 hours of the appointment. Obtain appropriate referrals and documentation from providers and upload to the correct folders in patient charts. Documentation & Reporting Maintain accurate and complete documentation in the patient's chart, including: Appointment details, Insurance information and Provider information Obtain and maintain active disability scripts at all times with appropriate fields, dates, and signatures. Collaborate with Internal Case Managers (ICMs) to update patient appointments and maintain organized charts. Complete required assessments as indicated, including ADL, IADL, SLUMS, and PHQ-9. Prepare and submit monthly reports per protocol. Ensure all documentation is uploaded in PDF format. Bill accurately and only for completed tasks; bill in real time when possible and ensure all weekly billing is completed by end of day Friday per the Billing Process. Medical Records & Information Management Identify required medical records and communicate requests to ICMs. Review incoming medical records for completeness and relevance. Utilize medical records to guide care coordination, reporting, and recommendations. Attorney & Adjuster Communication Obtain preferred method of contact for attorneys and insurance adjusters. Provide consistent and professional updates to attorneys and insurance adjusters, including: Monthly reports, Adjuster updates, 15-second attorney updates, Updated disability scripts, Medical records Notify attorneys of noncompliant patients. Insurance & Additional Assistance Obtain accurate information on insurance coverage types and PIP coverage and update the chart accordingly. Monitor claim phases (investigation, litigation, open/billable) and adjust charts. Support MACP claim processes in collaboration with attorneys and patients. Assist with additional benefits coordination, including: Wage loss, Attendant care, Household replacement services, Transportation reimbursement Develop care plans when required (e.g., limited PIP cases). Coordinate patient transfers or discharges according to established criteria and procedures, consulting the Team Lead on any decision that falls outside standard criteria. Notify patients, providers, attorneys, and adjusters of transfers or discharges. Communicate discharge status and completion with ICMs. Ensure all documentation and billing is complete and communicated to the discharge nurse. Professional Standards & Expectations Adhere to Ascendant Health's Core Values: Patient First, Teamwork, Proactivity, Integrity & Accountability, and Growth. Always maintain HIPAA compliance and confidentiality. Communicate professionally and respectfully with all care team members. Meet documentation, billing, and reporting timelines consistently. Ensure all billing entries correspond with completed and uploaded documents (e.g., POV forms, monthly reports, monthly updates). Maintain organized, updated, accurate, and complete patient charts. Direct case-approach questions and case decisions to your Team Lead; seek guidance and additional training when needed. Respond to all leadership requests within 24 hours of receiving communication. Attend company and marketing events as committed to. Success in This Role Looks Like Patients receive coordinated, timely, and compassionate care. Patients feel supported, informed, and engaged in their recovery. Patient charts are well organized, clearly labeled, and easy to navigate, allowing any authorized team member to locate key information quickly. Consistent and effective collaboration with ICMs, with clear communication, shared accountability, and mutual support. Providers, attorneys, and adjusters receive clear and consistent communication. Documentation is accurate, complete, and submitted on time. Care plans progress efficiently with minimal delays or escalations. Qualifications Active RN License in Michigan. Familiarity with Michigan auto no-fault / PIP and MACP processes preferred. Valid driver's license and reliable transportation for in-person appointments. Strong organization, documentation, and communication skills. What We Offer Competitive salary starting at $35/hr depending on experience. Health, dental, and vision insurance. Paid time off 401(k) or retirement plan up to 4% match #J-18808-Ljbffr Ascendant Health