RN Case Manager - Workers' Compensation
About The Position
A Workers’ Compensation Nurse Case Manager coordinates and manages the medical care of injured employees throughout the workers’ compensation claim process. The role evaluates medical needs and treatment progress, identifies barriers to recovery, educates stakeholders, and ensures care follows workers’ compensation regulations and best practices. NJM’s official job title is Medical Management Coordinator II/Telephonic Nurse Case Manager. The position works and communicates with the Medical Management team, Workers’ Compensation Claims team, Workers’ Compensation Claims Supervisors, and other team members. It may include on-site visits with injured workers, physicians, and other treatment providers when necessary, and travel within New Jersey or an assigned territory depending on business needs.
Requirements
- Registered Nurse (RN) required.
- Five years of clinical nursing experience required.
- Ability to travel within New Jersey or an assigned territory depending on business needs.
- Strong internal and external relationship management skills.
- Detail-oriented, with exceptional time-management and organizational skills.
- Ability to work independently and in a team environment.
- Proactive approach.
- Willingness to learn and grow within the position.
- Reliability and compliance with the company’s attendance policy.
- Intermediate Microsoft Office Suite skills (Outlook, Word, Excel, and PowerPoint) and ability to navigate technology and multiple systems.
- High school diploma or GED equivalent.
Nice To Haves
- Workers’ compensation or PIP experience preferred.
- Bachelor of Science in Nursing (BSN) preferred.
- Certified Case Manager (CCM) beneficial.
Responsibilities
- Apply case management standards of practice with demonstrated knowledge, skills, and competency.
- Develop and provide ongoing support for rehabilitation plans through comprehensive assessment, planning, implementation, and evaluation of individual claimant needs.
- Coordinate medical treatment, advocate for injured workers with providers and stakeholders, and educate injured workers about their recovery process.
- Comply with statutory, regulatory, and licensing requirements, as well as NJM policies and guidelines affecting utilization review, case management, and medical management.
- Attend on-site visits with injured workers, physicians, and other treatment providers when necessary.
- Evaluate the appropriateness, medical need, and efficiency of health care procedures and facilities using established criteria or guidelines.
- Communicate and collaborate with management, peers, and colleagues to support alignment, compliance, and effective management of assigned claims.
- Participate in or support identified project initiatives.
- Seek development opportunities and identify process improvements to improve operational effectiveness and minimize costs.
Benefits
- 401(k) with employer match up to 8% and additional service-based contributions.
- Health insurance.
- Dental insurance.
- Vision insurance.
- Life and disability coverage.
- Generous paid time off (PTO).
- Paid sick leave.
- Paid parental leave, in addition to state-mandated leave.
- Employees may be eligible for discretionary bonuses.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
