Nurse Case Manager/Operations
About The Position
Forthright Case Management is seeking a dynamic, highly organized, and relationship-focused Registered Nurse (RN) to serve in a dual Operations & Clinical Services role. This position is designed for an experienced nurse who can successfully balance operational leadership, client relations, business development, and administrative responsibilities while maintaining the ability to actively manage a nurse case management caseload as business needs require. The ideal candidate is a licensed RN with experience in workers' compensation, medical case management, utilization management, occupational health, or catastrophic injury management. They should possess excellent clinical judgment, strong communication skills, and the ability to transition seamlessly between direct case management and operational leadership. This individual will support Forthright's continued growth by overseeing daily operations, strengthening client relationships, assisting with referral management, supporting recruiting and onboarding, and providing high-quality nurse case management services.
Requirements
- Active, unrestricted Registered Nurse (RN) license.
- Minimum of 3 years of Nurse Case Management experience preferred.
- Experience in workers' compensation case management strongly preferred.
- Certified Case Manager (CCM) or willingness to obtain certification preferred.
- Excellent written and verbal communication skills.
- Strong clinical assessment and critical thinking abilities.
- Experience with Microsoft Office and electronic case management systems.
- Ability to travel locally for field case management and client meetings as needed.
Nice To Haves
- Experience in workers' compensation, medical case management, utilization management, occupational health, or catastrophic injury management.
Responsibilities
- Manage a caseload of workers' compensation nurse case management files when assigned.
- Coordinate medical treatment plans with injured workers, physicians, employers, adjusters, attorneys, and rehabilitation professionals.
- Attend physician appointments when appropriate.
- Evaluate treatment plans and identify barriers to recovery.
- Facilitate timely return-to-work planning.
- Prepare comprehensive case management reports that meet client expectations.
- Maintain documentation in accordance with state regulations, HIPAA, and client requirements.
- Provide telephonic and field case management services as needed.
- Serve as clinical backup for other Nurse Case Managers during vacations, leave, or increased caseloads.
- Oversee daily administrative and operational workflows.
- Coordinate new referrals and assign cases appropriately.
- Monitor case progression and reporting deadlines.
- Ensure exceptional client service and timely communication with referral sources.
- Develop and maintain strong relationships with insurance carriers, TPAs, employers, attorneys, and healthcare providers.
- Support billing, operational reporting, and quality assurance initiatives.
- Identify opportunities to improve efficiency and clinical outcomes.
- Represent Forthright Case Management at industry conferences, networking events, and client meetings.
- Assist with business development initiatives and relationship management.
- Support marketing efforts, including professional social media engagement and educational content.
- Strengthen existing client relationships while helping cultivate new referral sources.
- Assist with recruiting, interviewing, onboarding, and mentoring Nurse Case Managers.
- Support clinical orientation and ongoing professional development.
- Assist leadership with policy implementation and operational improvements.
- Promote Forthright's culture of collaboration, professionalism, and clinical excellence.
Benefits
- Bonus based on performance
- Flexible schedule
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
