Clinical Case Manager-RN-Hybrid-Jersey City, NJ

Alight

5d • Hybrid

About The Position

The Clinical Case Manager-RN will offer clinical expertise, act as a liaison in disability cases, and utilize MDGuidelines to support medically sound decisions. They will ensure effective administration of absence and disability claims while delivering compassionate care to client employees.

Requirements

• Be a Registered Nurse, Nurse Practitioner, or comparable license with experience, with working knowledge of disability, client processes, and case management.
• Have minimum of 5 years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review.
• Have minimum of 2 years' experience as a Clinical Case Manager.
• Demonstrate dedication to providing high quality customer service, using diplomacy, patient advocacy, and professional competency.
• Foster interest in collaborating with compassionate clinicians and leaders who prioritize mutual care and the well-being of customers and employees.
• Have relevant education and valid licensure.

Responsibilities

• Serving as primary resource on team managing medical disability and accommodation cases.
• Delivering case presentations to a panel, utilizing compelling communication, critical thinking, negotiation, holistic case analysis, and proactive case management skills.
• Displaying a professional/corporate presence and presentation style with the ability to demonstrate excellent problem-solving skills when questioned on your case management plans.
• Consulting on medical, behavioral health, and accommodation claims as needed, if within the scope of licensure and clinical expertise.
• Supporting employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations.
• Acting as a liaison between all parties required in case management to facilitate continuous communication and consensus.
• Serving as a liaison to the client's EAP, coordinate care, and encourage referrals to top behavioral health providers.
• Providing documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavor.
• Managing caseload efficiently, organizing priorities, provides timely interventions, and maintains sensitivity to confidential records. Driving return to work process from beginning of case to closure.
• Ensuring quality standards for case management are met; implement Alight’s continuous quality improvement process whenever efficiencies or quality standards are not met.

Benefits

• With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life.
• Benefits include health, dental and vision coverages starting Day One.
• Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities – all within a thriving global organization.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed