Workers' Compensation Nurse Case Manager

New York Workers' Compensation Nurse Case Manager – The Black Car Fund Hybrid (Long Island City, NY) or Fully Remote for candidates 75 miles or more from Long Island City. Salary: $105,000 - $115,000 per year + $2,500 signing bonus. Make an Impact on Where It Matters. The Black Car Fund provides workers' compensation insurance, safety education, and benefits to For-Hire drivers throughout New York. Role Overview Seeking an experienced New York Workers’ Compensation Nurse Case Manager or an RN willing to train and become a Certified Workers’ Compensation Nurse Case Manager (CCM). The role requires detail-driven, people-focused individuals delivering meaningful outcomes. What You Will Do Manage and process Prior Authorization Requests (PARs) submitted by treating providers through the OnBoard system. Provide case management in a workers’ compensation environment, documenting assessment and care plans for the injured worker. Develop treatment plans balancing quality of care and cost-effectiveness under the NYS Medical Treatment Guidelines, including ODG/Presley Reed criteria. Adhere to URAC standards; certification preferred but not required. Provide utilization review of treatments and recommend approval or denial to claims adjusters, based on medical documentation, guidelines, and nursing standards of care. Collaborate with the Claims Team and Nursing Team. Participate in file reviews and roundtables on complex and catastrophic cases. Prepare clear, concise documentation reflecting strong clinical knowledge. Manage vendor relationships when assessing or managing cases. Serve as a medical resource for Claims Management staff. Provide claim review services on cases as needed per BCF policy and procedure. What You Bring You are a nursing professional who thrives in a demanding environment and balances medical expertise with sound judgment. Minimum work experience requirement verified by documentation. 90‑day evaluation period applies. Experience, Certifications & Skills Associate or bachelor’s degree in nursing; NYS registered professional nurse license required. Five or more years of clinical nursing experience preferred. CCM or COHN certification preferred; non‑certified candidates must intend to pursue certification. Understanding of or certification in URAC standards preferred. Completion of NYS Workers’ Compensation Medical Treatment Guideline training. Knowledge of New York workers’ compensation, disability, and managed care law preferred. Customer focus, composure under pressure, and strong interpersonal skills. Effective verbal and written communication, decision‑making, and critical thinking. Multi‑tasking, time management, and adaptability. Proficiency in Microsoft Office Suite. Specialties Critical & Intensive Care Medical‑Surgical Occupational Medicine Physical & Rehabilitation Medicine Primary Care Surgery Benefits & Compensation Competitive salary and signing bonus; health care benefits with limited employee contribution; 401(k) with 100% employer match up to 6% of salary; ROTH 401(k); 100% employer‑paid life, dental, and vision insurance; paid vacation and sick time; pre‑tax transit benefits; flexible spending account; lifestyle spending account; pet discount program; Employee Assistance Plan; hybrid work‑life balance; team‑oriented culture; career growth opportunities. Location & Work Arrangement Hybrid schedule for residents within 75 miles of Long Island City. Remote schedule for candidates 75 miles or more from Long Island City. Equal Opportunity Employer The Black Car Fund is an equal‑opportunity employer. We strongly encourage qualified military veterans and spouses to apply. #J-18808-Ljbffr