22 telephonic nurse case manager jobs found

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  The Telephonic Nurse Case Manager provides medical and disability case management services within the Workers' Compensation claims department. Responsibilities include assessing injured worker needs, applying evidence-based case management principles, and collaborating with healthcare providers, employers, claimants, and claims professionals to support timely decision-making, appropriate treatment, and return-to-work outcomes. This position works a hybrid work schedule of 2 days per week in office. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Assesses disability status, makes recommendations...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager Please Note: This is a hybrid position requiring onsite attendance at our Baltimore - St. Paul office (7 St. Paul Street, Suite 450 Baltimore, MD 21202) on Tuesdays and Thursdays each week , with remote work available on the remaining business days. PRIMARY PURPOSE OF THE ROLE: While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to: ·        Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability. ·        Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services. ·        Prepare and deliver trainings to claims...

Description The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs. They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the BCBSM online messaging platform. The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s health across the care continuum. They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals. Lead the coordination of a  multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally. The multidisciplinary team is inclusive of Medical and Behavioral Health Social...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Scottsdale, AZ or remote in Arizona. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively,...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position is remote in Texas. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or retrospectively in...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position is remote in Pennsylvania! Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where your clinical talent and leadership abilities contribute to our competitive edge.    PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of Maitland, FL or Boca Raton, FL office.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively,...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Irvine, CA, Scottsdale, AZ or Salt Lake City, UT.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

Overview AmTrust Financial Services, a  fast growing  commercial insurance company, has a need for a Complex Care Case Manager, RN for Workers Compensation managed care team.     PRIMARY PURPOSE :   The  complex care case manager will provide comprehensive and quality telephonic case management for our injured employees with complex diagnoses and often catastrophic injuries. Our nurses will  be responsible for  proactively applying clinical  expertise  ensuring our injured employees receive medically  appropriate healthcare  to achieve a safe return to work or best  optimal  level of function through engagement with the injured employee,  provider  and employer. Our nurses will be empathetic informative medical resources for our injured employees, and they will partner with our adjusters to develop a personalized  holistic approach  for each claim.  These responsibilities may include  utilization  review, pharmacy oversight...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...

Position Summary: The Clinical Health Navigator, RN serves as a trusted clinical resource for employees and their families enrolled in self-funded health plans, helping them navigate complex healthcare decisions and access high-quality, appropriate, and cost-effective care. The Clinical Health Navigator builds ongoing, trust-based relationships with members and provides personalized guidance when healthcare becomes difficult to understand or navigate. The Navigator applies clinical knowledge, healthcare-system expertise, and benefits awareness to help members make informed decisions and overcome barriers to care. Essential Tasks: Guide members through complex healthcare moments.  Build direct, trust-based relationships with employees and their families navigating serious diagnoses, high-cost treatments, complex care journeys, or difficult healthcare decisions. Help members understand their clinical situation, available options, and benefits well enough to make informed...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has a need for a Clinical Pharmacist. Candidates located within a reasonable commuting distance of our Overland Park, KS office will be considered.   PRIMARY PURPOSE:  The Clinical Review Pharmacist has the responsibility of reviewing the medical necessity, appropriateness, and quality in the appropriate setting for workers’ compensation injured employee as it pertains to their medications. Additionally, they will work with Amtrust adjusters and nurses to take proper interventions in the care of the injured employee. This position primarily requires timely reviews of pharmacy prior authorizations to determine appropriateness and medical necessity of treatment. This position assesses the medical appropriateness of proposed medications for our injured employees and partners with the AmTrust claims team to expedite medically necessary treatment....

WHAT WE'RE LOOKING FOR Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Adjuster.   Upon successful completion of the Claims Training program, the Claims Examiner Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution.  Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations.  This individual will continue to build on claims knowledge and claims will increase in number and complexity.     RESPONSIBILITIES Completes classroom training introducing workers’ compensation claims handling strategies, medical terminology, and legal concepts. Learns skills such as...

WHAT WE'RE LOOKING FOR Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Adjuster.   Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution.  Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations.  This individual will continue to build on claims knowledge and claims will increase in number and complexity.     RESPONSIBILITIES Completes classroom training introducing workers’ compensation claims handling...

Why Arbella? At Arbella, we’re focused on people. We work hard to attract and retain the best. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages. We invest in our employees and encourage them to grow so that we, too, can grow as a company. Other perks include: • Company nurse, nutritional counseling, and mental health resources • Tuition assistance programs • Opportunities to get involved: Arbella Activities Committee, Diversity and Inclusion Council, and more • A company committed to community: volunteer opportunities, employee- led community efforts, and the Arbella Insurance Foundation • Robust training, mentorship, and professional/personal development programs • Colleagues who genuinely care about each other Arbella is committed to building a workplace that’s diverse, inclusive, and equitable for everyone. We’ve created a culture that supports a diverse...

Introduction Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional. Overview Prioritize and manage an assigned caseload of medical and disability workers compensation claims according to Zenith guidelines, performing UR and telephonic case management, as indicated....

Why Arbella? At Arbella, we’re focused on people. We work hard to attract and retain the best. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive, industry-leading salaries and benefits packages. We invest in our employees and encourage them to grow so that we, too, can grow as a company. Other perks include: • On-site gym and fitness classes and one-on-one personal training • On-site nurse, nutritional counseling, and mental health resources • Full-service cafeterias • Free shuttle service to Quincy Adams T Station • Tuition assistance programs • Opportunities to get involved: Arbella Activities Committee, Diversity and Inclusion Council, and more • A company committed to community: volunteer opportunities, employee-led community efforts, and the Arbella Insurance Foundation • Robust training, mentorship, and professional/personal development programs • Colleagues who...