Description
RN Case Manager – Colorado Springs, CO Region
💻 Remote position + local field travel
💰 Salary: Competitive & commensurate with experience
🎉 Quarterly Bonus Opportunities
📚 Free CEUs for licenses & certificates
💳 License & Certification Reimbursement
We’re looking for an RN with a passion for case management to join our team!
✨ RN degree required
✨ National Certification preferred (CCM, CRC, COHN, CRRN)
✨ Workers’ Comp Case Management experience a plus
Your Impact
- You’ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines.
- You’ll support patients/employees receiving benefits under insurance lines including Workers’ Compensation, Group Health, Liability, Disability, and Care Management.
- This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
- Apply today and make an impact in the community!
Responsibilities
- Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.
- Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.
- Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.
- May perform job site evaluations/summaries to facilitate case management process.
- Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer.
- Coordinate RTW with injured worker, employer and physicians.
- Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services.
- Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.
- May obtain records from the branch claims office.
- May review files for claims adjusters and supervisors for appropriate referral for case management services.
- May meet with employers to review active files.
- Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.
- Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.
- May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.
- Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.
- Reviews cases with supervisor monthly to evaluate files and obtain directions.
- Upholds the Crawford and Company Code of Business Conduct at all times.
- Demonstrates excellent customer service, and respect for customers, co-workers, and management.
- Independently approaches problem solving by appropriate use of research and resources.
- May perform other related duties as assigned.
Qualifications
- Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.
- Minimum of 1-3 years diverse clinical experience and one of the below:
- Certification as a case manager from the URAC-approved list of certifications (preferred);
- A registered nurse (RN) license.
- Must be compliant with state requirements regarding national certifications.
- General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
- Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
- Excellent