Telephonic Case Manager I

This is a Fully Remote Job About Our Client: The organization is a national provider of risk management solutions focused on workers' compensation, auto, health, and disability management industries. Established in 1987 and publicly traded since 1991, it combines investment in human capital and technology to deliver integrated solutions. With a workforce of over 4,000 across the United States, the organization maintains a stable and growing presence with a culture emphasizing accountability, commitment, excellence, integrity, and teamwork. About the Opportunity: The TELEPHONIC CASE MANAGER I is responsible for coordinating medical resources and developing personalized, cost-effective care plans for individuals who are ill or injured. This role assesses treatment plans for appropriateness and works with physicians and patients to recommend alternatives when necessary. The position supports quality treatment and facilitates timely return to work, contributing directly to effective case management and cost containment. Responsibilities: Provide medical case management through coordination with patients, physicians, healthcare providers, employers, and referral sources Assess, plan, implement, and evaluate patient progress Evaluate treatment plans for medical necessity, appropriateness, and cost effectiveness Discuss current and alternative treatment plans with physicians using medical expertise Recommend treatment plans to payers Coordinate delivery of medical equipment and nursing services Develop cost-effective medical care strategies Prepare organized reports within deadlines Maintain a minimum productivity standard of 95% per month Perform additional duties as assigned Requirements: Bachelor’s degree required; BSN preferred Graduate of accredited nursing school Current RN licensure in state of operation Minimum of 3 years recent clinical experience, preferably in rehabilitation URAC-recognized Case Management certification required within 3 years if not present at hire Preferred clinical background in orthopedics, neurology, or rehabilitation Cost containment experience, such as utilization review or managed care, is helpful Certification as CIRS or CCM preferred Pay Range and Compensation Package: Pay range: $63,739 - $95,264 Salary ranges are market-based and may vary depending on location, skills, experience, qualifications, and other factors Benefits & Perks: Medical insurance (HDHP) with Pharmacy Dental insurance Vision insurance Long Term Disability Health Savings Account Flexible Spending Account options Life Insurance Accident Insurance Critical Illness Insurance Pre-paid Legal Insurance Parking and Transit FSA accounts 401(k) and ROTH 401(k) Paid time off Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.