Telephonic Case Manager - Green Bay, WI

TRIUNE Health Group • Green Bay, WI

7d • Remote

About The Position

The Telephonic Case Manager provides clinical case management services to injured or ill individuals primarily through telephonic and electronic communication. This role focuses on care coordination, treatment planning, patient education, and resource facilitation to promote quality outcomes, cost-effective care, and timely return to work when appropriate.

Requirements

• Graduate of an accredited school of nursing.
• Current RN licensure in the state of operation.
• Fluency in English (speaking, reading, and writing).
• Three or more years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, and neurology.
• Strong clinical judgment and critical thinking skills
• Excellent verbal and written communication skills, with the ability to build rapport telephonically
• Highly organized, detail-oriented, and able to manage multiple cases simultaneously
• Ability to work independently while collaborating with a remote team
• Proficient in Microsoft Office Suite (Word, Excel, Outlook) and web-based systems
• Professional, empathetic, and solution-oriented approach to case management
• Dependable, adaptable, and comfortable in a fast-paced, remote environment

Nice To Haves

• CCM preferred.
• While not required, candidates with one or more of the following certifications are preferred: CCM COHN / COHN-S CDMS

Responsibilities

• Provide telephonic medical case management services through ongoing communication with injured workers, treating providers, employers, and referral sources
• Apply the core steps of Case Management, including assessment, planning, implementation, monitoring, and evaluation of care plans
• Review and evaluate treatment plans for medical necessity, appropriateness, and cost-effectiveness
• Coordinate care and services such as diagnostics, specialist referrals, durable medical equipment, and home health services as needed
• Communicate medical information clearly, professionally, and compassionately to patients and stakeholders
• Educate patients on diagnoses, treatment plans, recovery expectations, and return-to-work processes
• Identify barriers to recovery and collaborate with the care team to develop solutions
• Maintain timely, accurate, and well-organized documentation and reports in compliance with HIPAA and company standards
• Stay current on medical terminology and applicable federal and state regulations, including Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA
• Utilize technology effectively, including case management systems, Microsoft Office applications, phone systems, and secure communication tools
• Research and recommend appropriate medical and community resources for individuals with acute, chronic, or catastrophic conditions
• Perform other duties as assigned

Benefits

• Generous Time Off: 20 days of vacation plus 8.5 paid holidays
• Retirement Savings: 401(k) match to help you plan for the future
• Comprehensive Insurance: Medical, dental, and vision coverage
• Disability Coverage: Short-Term (STD) and Long-Term Disability (LTD) insurance
• Employee Support: Employee Assistance and Referral Program
• Work-from-Home Essentials: Home office equipment, including a laptop and desktop monitor
• Travel Perks: Mileage and travel reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree