Triage Telephonic Nurse Case Manager

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🏈 Alabama – Remote

🏈 Alabama – Remote

💵 $66k - $67k / 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

• Conduct initial triage and telephonic case management at the outset of Workers’ Compensation claims. • Perform clinical assessments of injured workers to determine appropriate medical care and treatment pathways. • Complete initial assessment and required three-point contact in accordance with State of Florida procedures and emergency protocols. • Develop an initial case management care plan based on clinical findings and information obtained from the injured worker, employer, and medical provider. • Identify potential causation concerns or barriers to recovery and document findings appropriately. • Facilitate communication between injured workers, employers, claims professionals, healthcare providers, and rehabilitation specialists. • Monitor treatment plans to ensure adherence to state-mandated treatment guidelines and evidence-based medical protocols. • Address initial return-to-work capabilities with injured workers and providers, documenting updates in the case management system. • Maintain accurate and timely documentation of all contacts, interviews, and medical information in the claims management system. • Identify opportunities for cost-effective medical management and appropriate utilization of services. • Educate injured workers and their families about recovery expectations and care plans. • Maintain strict patient confidentiality and compliance with state and federal healthcare regulations. • Serve as a patient advocate, ensuring quality care and adherence to ethical and regulatory standards. • Participate in quality assurance initiatives, committees, and department activities as required. • Assist with training claims staff on identifying medical case management opportunities, as needed.

🎯 Requirements

• Registered Nurse (RN) with an active and unrestricted state license • Minimum of 3 years of clinical nursing experience (medical-surgical, orthopedic, neurological, ICU/CCU, occupational health, or related specialty). • Workers’ Compensation case management experience preferred. • Prior telephonic case management or triage experience preferred. • Strong understanding of clinical documentation and patient advocacy principles. • Strong clinical assessment and triage skills in a Workers’ Compensation or occupational health environment. • Knowledge of Workers’ Compensation medical case management practices and treatment guidelines. • Ability to identify barriers to recovery and develop appropriate care strategies. • Excellent verbal and written communication skills, with the ability to work collaboratively with multiple stakeholders. • Strong organizational and documentation skills with attention to detail. • Ability to work independently and manage multiple priorities in a fast-paced environment. • Proficiency with computer systems, case management software, and Microsoft Office applications. • Commitment to high-quality patient care, confidentiality, and regulatory compliance.

🏖️ 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