Clinical Case Manager-RN

Alight Solutions

1d•$95,000 - $125,000•Remote

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.