2 medical case manager jobs found in Trenton, NJ

Reporting directly to the Medical Management Supervisor, the Workers' Compensation (WC) Case Manager supports the WC Department by following the best practices associated with managing of the injured worker effectively and efficiently. The position requires the nurse to work and communicate with other members of the Medical Management team in addition to the WC Claims team, WC Claims Supervisors, and other team members. The WC Team Lead also interacts with the associated injured parties or their legal representatives, medical providers, and other departments within NJM, as needed. The official NJM job title is Medical Management Coordinator. Essential Duties and Responsibilities: Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.  Facilitate...

The overall responsibility of this position is to consistently execute on the Company’s mission, vision, and values, leading customer service approach, and claims business model to provide best outcomes on complex/high severity claims. The Complex Claims Specialist, Senior will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim, and implement an action plan to manage the claim. The Complex Claims Specialist, Sr will work with and communicate to NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, Special Investigation Unit, WC Legal Staff, other departments within NJM, and vendors as needed. This is a senior level position in the Complex Claims track that will require minimal supervision and guidance to accomplish the goals and objectives of the role. Essential Duties and Responsibilities: Review, investigate, and analyze...