Senior Nurse Case Management Analyst, Bilingual

Job not on LinkedIn

October 28

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

⏰ Full Time

🟠 Senior

🧐 Analyst

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MedRisk

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Healthcare Insurance • B2B • SaaS

MedRisk is a managed care organization that specializes in improving recovery and payment integrity for workers' compensation and occupational injury cases. The company combines clinical triage, scheduling, patient engagement, network management, and analytics to connect patients with appropriate care, streamline authorizations, and deliver secure electronic payments. MedRisk provides services and technology platforms for payers, providers, and patients to optimize spending, ensure compliance, and translate data into actionable insights.

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

🤝 B2B

☁️ SaaS

📋 Description

• Ensure optimum recovery on every claim while establishing trust, providing education, delivering information, and care. • Provide case direction to field case managers when on-site intervention is required. • Collaborate with clients and business partners to ensure quality standards are maintained for all accounts. • Demonstrate knowledge, skills, and competency in the application of case management standards of practice. • Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan. • Interview injured persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational. • Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient. • Work with employers and physicians to modify job duties where practical to facilitate early return to work. • Evaluate and modify case goals based on injured/disabled persons’ improvement and treatment effectiveness. • Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.

🎯 Requirements

• Bachelor’s Degree in nursing or related field • Active Registered Nurse (RN) license required. Must be in good standing. • 2+ years clinical practice preferred. • Workers’ compensation-related experience preferred. • Professional certification in Case Management required (CCM, CRC, CRRN, COHN), Disability Management (CDMS), or Qualified Rehabilitation Provider (QRP). • Ability to advocate recommendations effectively with physicians/providers, employers, and customers. • Ability to work independently. • Knowledge of basic computer skills including Excel, Word, and Outlook Email. • Proficient grammar, sentence structure, and written communication skills. • Show organizational and planning skills. • Bilingual in English and Spanish required.

🏖️ Benefits

• Bilingual Required • Experience working in California