RN Telephonic Nurse Case Manager

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🏈 Alabama – Remote

🏈 Alabama – Remote

💵 $75k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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MDD Forensic Accountants

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1933

💸 Finance

Finance • Insurance • Consulting

MDD Forensic Accountants is a forensic accounting firm specializing in business valuations, shareholder disputes, and economic damage quantification. With over 40 offices globally, MDD provides expertise across a wide range of industries, delivering services to insurance companies, law firms, governments, and individuals. Their services include business interruption, lost profits, fraud investigations, and more, making them a trusted advisor for sound financial decision-making.

📋 Description

• Manage a caseload of Workers’ Compensation claims through telephonic case management services • Conduct comprehensive initial and ongoing assessments of injured employees’ medical status, treatment progress, and recovery needs • Develop, implement, and monitor individualized case management plans to promote optimal medical outcomes. • Review medical records, treatment recommendations, and clinical information to determine appropriateness of care. • Identify barriers to recovery and develop action plans to facilitate progress toward recovery and return-to-work goals. • Monitor adherence to evidence-based treatment guidelines, utilization criteria, and regulatory requirements. • Evaluate treatment plans and document clinical outcomes, recovery progress, and return-to-work milestones. • Act as a liaison among injured employees, employers, healthcare providers, insurers, attorneys, and other authorized stakeholders. • Facilitate effective communication to ensure alignment on treatment plans, recovery goals, and return-to-work expectations. • Establish and maintain strong client relationships through professional service and responsive communication. • Serve as a patient advocate while maintaining compliance with legal, ethical, and regulatory standards. • Address return-to-work capabilities with injured employees and treating providers during ongoing case reviews. • Collaborate with employers and providers to support transitional or modified duty opportunities when appropriate. • Obtain and review job descriptions to assist providers in evaluating work capacity and restrictions. • Promote timely and medically appropriate return-to-work outcomes. • Maintain accurate, timely, and comprehensive case documentation within designated systems. • Ensure compliance with state Workers’ Compensation regulations, client requirements, and company policies. • Protect confidential medical information in accordance with HIPAA and applicable privacy regulations. • Support utilization review processes, including pre-authorization, concurrent review, retrospective review, and medical director referrals as needed. • Monitor provider and vendor performance to ensure quality service delivery. • Identify opportunities for process improvement and operational efficiencies. • Participate in quality assurance, grievance, and other organizational committees as assigned. • Provide clinical education and support to internal staff and stakeholders when appropriate. • Assist with training, mentoring, or guidance of less experienced team members as requested. • Perform other duties as assigned.

🎯 Requirements

• Minimum three (3) years of clinical nursing experience in one or more of the following areas: • - Medical-Surgical • - Orthopedics • - Neurology • - Critical Care/ICCU • - Emergency Room • - Occupational Health • - Industrial Nursing • Workers’ Compensation case management experience preferred. • Telephonic case management experience preferred. • Current, unrestricted Registered Nurse (RN) license in the applicable state(s). • Ability to maintain active licensure throughout employment. • Strong clinical assessment and critical thinking skills. • Knowledge of Workers’ Compensation processes, regulations, and medical case management principles. • Understanding of evidence-based treatment guidelines and disability management practices. • Ability to manage multiple priorities independently in a fast-paced environment. • Strong organizational and time-management skills. • Excellent verbal and written communication skills. • Ability to build collaborative relationships with diverse stakeholders. • Strong customer service orientation and professionalism. • Proficiency with Microsoft Office applications and case management software systems. • Ability to maintain confidentiality and exercise sound clinical judgment. • Minimal travel may be required based on business needs.

🏖️ Benefits

• Medical, dental, and vision plans to support your health and that of your family • A 401(k) plan with employer matching • Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees • Paid holidays • Life insurance and short‑term and long‑term disability coverage • Paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements