Clinical Case Manager-Registered Nurse

Alight•Virtual, NJ

11d•$95,000 - $125,000

About The Position

The Clinical Case Manager-RN provides clinical expertise and serves as a liaison in disability cases, using MDGuidelines to support medically sound decisions. The role supports effective administration of absence and disability claims while providing compassionate care to client employees. The case manager leads case management from beginning through closure, supporting return to work when individuals are medically able, and works with employees, employers, clinicians, and other parties to facilitate communication and informed decisions. The position also coordinates with the client's Employee Assistance Program (EAP), supports referrals to behavioral health providers, and helps ensure case management quality standards through Alight's continuous quality improvement process. The role requires professional communication, sound clinical judgment, patient advocacy, confidentiality, and efficient caseload management. Alight notes that occasional travel to a physical office location may be required. Virtual interviews are conducted by video.

Requirements

Be a Registered Nurse, Nurse Practitioner, or hold a comparable license, with relevant experience and working knowledge of disability, client processes, and case management.
Have at least 5 years of medical advisory experience in occupational health, workers' compensation, disability, health case management, or utilization review.
Have at least 2 years of experience as a Clinical Case Manager.
Demonstrate dedication to high-quality customer service, diplomacy, patient advocacy, and professional competency.
Have relevant education and valid licensure.
Have work authorization in the employing country that does not now or in the future require visa sponsorship.

Responsibilities

Serve as the primary team resource for medical disability and accommodation cases.
Present cases to a panel using effective communication, critical thinking, negotiation, holistic case analysis, and proactive case management.
Demonstrate a professional corporate presence and presentation style, and respond to questions about case management plans with strong problem-solving skills.
Consult on medical, behavioral health, and accommodation claims when within the scope of licensure and clinical expertise.
Support employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations.
Act as a liaison among parties involved in case management to facilitate ongoing communication and consensus.
Serve as a liaison to the client's EAP, coordinate care, and encourage referrals to leading behavioral health providers.
Provide documentation, feedback, and reports to diverse occupational populations, with an emphasis on returning medically able individuals to productive work.
Manage caseload and priorities efficiently, provide timely interventions, protect confidential records, and drive the return-to-work process from case opening through closure.
Ensure case management quality standards are met and implement Alight's continuous quality improvement process when efficiency or quality standards are not met.