RN Case Manager, Workers Compensation

Endeavor Health•Arlington Heights, IL

7d•Hybrid

About The Position

The RN Case Manager, Workers Compensation provides care coordination and case management to injured team members, focusing on facilitating their return to work. This role ensures timely, efficient, and coordinated care that promotes optimal recovery, safe return to work, and compliance with all relevant regulatory and organizational policies. The RN Case Manager serves as a liaison among injured team members, providers, Endeavor’s third-party administrator, legal representatives, and leaders to ensure a safe and seamless process as they return to work from a medical absence or an approved medical leave of absence.

Requirements

Bachelor’s degree in Nursing or Healthcare/Science, required
Registered Nurse (RN) – Illinois Department of Financial and Professional Regulation, required
BLS – Basic Life Support (CPR & AED) through the American Heart Association, required
3+ years of clinical nursing experience

Nice To Haves

Certification in case management (CCM) or related field, preferred
Proficient in MS Word, Excel, and Powerpoint
Knowledge of workers compensation laws/regulations and claim management practices
Strong problem-solving skills
Attention to details
Compassionate and caring nature

Responsibilities

Coordinates the medical care of team members with work related injuries and/or illnesses from initial injury/illness through return to work or case closure.
Performs in-person, telephonic, and/or video visit assessments to monitor medical progress and identify potential barriers to recovery.
Communicates regularly with workers’ compensation carriers, third-party administrators (TPAs), and legal teams to manage claims and facilitate case resolution.
May coordinate and schedule tests, procedures, appointments, and treatments, ensuring services are received in a timely manner when necessary.
Collaborates with physicians, therapists, and other providers to ensure appropriate treatment plans are developed and followed.
Develops and implements individualized return-to-work (RTW) plans in coordination with Employee Health, Human Resources, and departmental leadership.
Monitor compliance with treatment and return-to-work protocols; escalate issues when necessary.
Works closely with team member’s care team to determine functional capacity and work status.
May also participate in communicable disease clearance for team members for team members seeking to return to work due to a non-occupational related illness (i.e shingles, conjunctivitis).
Maintains accurate, detailed reports and records.
Documents all case activity accurately and timely within the case management system (Team Member Health System) in accordance with internal policies and state regulations.
Provides patient care in compliance with NPSG and Core Measures.
Maintains continuous Joint Commission readiness.
Complies with HIPAA regulations.
Identifies and supports patient safety and infection control protocols
Builds relationships with team members and leaders across Endeavor Health in support of organizational and team objectives.
Responds thoroughly and promptly to customer needs and actively manages customer/peer relationships.
Participates in regulatory processes, surveys, and inspections, as needed.
Creates and builds positive relationships both internally and externally and effectively communicates with Executive Leadership, Operational Management, team members, vendors and contractors.
Stays abreast of regulations, trends, benchmarks and best practice and incorporates new knowledge into organizational programs and plans
Acts as a change agent to systematically drive and implement change throughout the organization in support of advancing the health, safety, and wellbeing of the workforce.
Educates team members on the workers’ compensation process, available resources, including health, safety, and wellness practices.
Maintaining confidentiality of team member and/or patient information.
Sensitive to time and budget constraints.
This role may support additional projects, perform administrative tasks, and other duties as assigned.