clinical nurse case manager

Kaiser Permanente

<div><div><b>Job Summary:</b></div><br>
<br>
<p>The Complex Case Manager is a Nationally Board Certified Professional. He/she is responsible for performing all activities on members referred to the complex case management program. This includes a comprehensive clinical evaluation, assessment and documented care plan in all domains including social determinants of health, psycho-social, financial, medications, ADL/IADLs and cognitive, coordinating and monitoring all services needed with a focus on providing education and the goal of self-management skills. Additional responsibilities include ensuring continuity of care through interaction and team- work with the Inpatient Case/Care Managers, Transition of Care staff, QRM staff, Population Care staff, Medical Office staff, Social Workers, Vendors and other KPGA staff. Educates Providers, member and caregivers and the promotion of quality care and a high level of member and/or caregiver satisfaction. The Complex Case Manager will ensure work demonstrates adherence to NCQA Standards of Excellence.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Reviews all referrals to the Complex Case Management Programs within designated timeframe per policy and procedure and evaluate for case management based on established guidelines to ensure compliance with NCQA standards. This includes the preliminary evaluation of benefits within KPGA and community resources available.</li><li>
Performs a thorough and objective assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of EMR and hospital records, contact with the member, significant others, caregivers and current medical caregivers (if permitted by the member).</li><li>
Obtains consent from the member/caregiver for participation in Complex Case Management.</li><li>
Develops a comprehensive plan of care based on the assessment and in conjunction with the treating practitioner, identifies specific interventions, objectives, and goals with anticipated targeted dates for member accomplishment and self-management.</li><li>
Communicates the plan of care to the member/caregiver and provides education to the regarding the members condition as necessary.</li><li>
Implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined in the plan of care.</li><li>
Establishes specific dates for follow-up and assesses the members status and progress toward the established goals and adjusts the plan of care as necessary.</li><li>
Performs referrals to other KPGA programs and coordinate referrals to community resources necessary to accomplish the goals and makes recommendations for modifications to the plan of care as necessary.</li><li>
Continuously evaluates and monitors all activities and/or services provided through the case management plan to determine the effectiveness of the plan.</li><li>
Documents all case management interactions and interventions according to guidelines including any pertinent patient information or arrangements in the members medical record.</li><li>
Identifies and Evaluates expected outcomes, utilization of services and associated costs of the plan of care as well as any proposed alternative plan of care and makes the necessary revisions.</li><li>
Coordinates and participates in case conferences on a regular basis with all Providers involved in the care and updates the plan of care as necessary.</li><li>
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered in the most appropriate setting.</li><li>
Assists in the development and implementation of Continuous Quality Improvement (CQI) projects.</li><li>
Works closely with the member and practitioner to ensure that the most appropriate and cost- effective services are always provided to the member while maintaining quality outcomes.</li><li>
Performs hospital discharge follow up on assigned population. Arranges, coordinates, and facilitates appointments for the member as necessary.</li><li>
Maintains effective interaction/communication with members, nursing staff, inpatient care coordinators, the transitional review team, social workers, general reviewers, referral coordinators, and Kaiser Permanente medical offices to facilitate the case management process and to provide continuity of care.</li><li>
Identifies the need for discharge from the Case Management Program based on defined goals and criteria, and discharges the member after notifying the member and practitioner as well as any other resources such as the Social Worker, Transitional Review Team, etc.</li><li>
Performs as an integrated health care team member, providing continual education to HCT staff as to role and responsibilities in care coordination. Remains accessible to the HCT and attends all HCT meetings as appropriate.</li><li>
Collaborates effectively with Providers and other departments within the health plan by acting as a resource to TSPMG Providers, contracted consultants, Health Plan administrators and medical office staff and other departments within the organization.</li><li>
Provides case management updates to Providers and health care teams.</li><li>
Performs home visits as appropriate for members in case management.</li><li>
Knowledgeable and compliant with regional personnel, unit specific and departmental policies and procedures. Assists in the development of department protocols as needed.</li><li>
Participates in annual regional and departmental compliance training.</li><li>
Knowledgeable and compliant with Principles of Responsibility.</li><li>
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job.</li><li>
Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI).</li><li>
Demonstrates doing the right thing and doing things the right way is an underlying premise in all work- related activities and is able to identify location of copy of Principles of Responsibility.</li><li>
Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong- doing and promptly investigates and reports to immediate supervisor or Director of Regional Compliance. Serves as a primary contact person between the medical offices and community agencies as it relates to coordinating and facilitating the appropriate level of care and provision of services.</li><li>
Collaborates with the social worker to provide information to members and HCTs regarding community resource referrals.</li><li>
Remains knowledgeable of contract benefits and current, industry utilization trends relevant state and Federal regulations, criteria, documentation requirements (including Medicare and HCFA) and laws that affect managed care and case/utilization management.</li><li>
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Team Leader and/or Manager.</li><li>
Under the guidance of the Team Leader and in consultation with other QRM and IQM staff, participates in the coordination, planning, development, implementation, and maintenance of all Complex Case Management Program department policies and procedures.</li><li>
Reviews the statistics of case management interventions with the Supervisor/Team Leader and adjusts based on findings.</li><li>
Performs quality of care and service reviews using identified quality indicators and refers cases identified as risk management, peer review or quality issues to Quality and Risk Management.</li></ul><div><br>
<b>Basic Qualifications:</b></div>
<div>Experience</div><br>
<br>
<ul><li>Minimum five (5) years of RN Clinical Nursing, social work, case management or utilization management (UM).</li><li>
Equivalent combination of case management/social work/UM training or RN experience may be considered.</li></ul><div>
Education</div><br>
<br>
<ul><li>High School Diploma or General Education Development (GED) required.</li></ul><div>
License, Certification, Registration</div>
<ul><li>Licensed Master Social Worker (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Registered Professional Nurse License (Georgia) required at hire
</li></ul><ul><li>Case Manager Certificate within 12 months of hire from Commission for Case Managers Certification<br>
</li></ul><div>
<b>Additional Requirements:</b></div><br>
<ul><li>
Complex Case Management experience and/or certification.
</li><li>Excellent/highly skilled in the management of chronic conditions such as diabetes, cardiovascular conditions, behavioral-health, and chronic obstructive lung disease management COPD.</li><li>
Ability to work collaboratively with multiple healthcare professionals.</li><li>
Experience with managed health care delivery, benefits knowledge including Medicare and Medicaid.</li><li>
Functional knowledge of computers.</li><li>
Knowledge of ICD9/ ICD10 and/or CPT4 coding beneficial.</li><li>
Working knowledge of all relevant federal, state, local and regulatory requirements including Medicare/HCFA.</li></ul><div>
<b>Preferred Qualifications:</b></div><br>
<br>
<ul><li>Bachelors Degree in Nursing strongly preferred or four (4) years of experience in related field.</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Individual Contributor<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - Rgnl Mg Admn-Ccs Case Coord - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

Complex Case Manager

Hill Physicians Medical Group

<div><p><b>We&rsquo;re delighted you&rsquo;re considering joining us!</b></p><p>
At Hill Physicians Medical Group, we&rsquo;re shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.</p><p></p><p><b>
Join Our Team!</b></p><p>
Hill Physicians has much to offer prospective employees. We&rsquo;re regularly recognized as one of the &ldquo;Best Places to Work in the Bay Area&rdquo; and have been recognized as one of the &ldquo;Healthiest Places to Work in the Bay Area.&rdquo; When you join our team, you&rsquo;re making a great choice for your professional career and your personal satisfaction.</p><p></p><p><b>
DE&amp;I Statement:</b></p><p>
At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are.</p><p></p><p>
We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right!</p><p></p><p><b>
Job Description:</b></p><p></p><p>
Responsible for carrying out case management activities for IPA members referred to the case management program across all levels of care. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet the client&rsquo;s health and human service needs. It is characterized by advocacy, communication and resource management and promotes quality and cost-effective interventions and outcomes. Case management activities are based on nationally recognized case management standards and concepts and principles. All contacts are telephonic with an option for on-site case conferences as needed.</p><p></p><p><b>
Job Responsibilities</b></p><ul><li>
Identification of members appropriate for case management, based on identification of health-related problems.</li><li>
Assessing members&rsquo; physical and psychosocial needs/barriers.</li><li>
Developing the case management care plan.</li><li>
Developing and implementing the interventions needed to resolve barriers and coordinate care, allowing members to accomplish their goals with physician guidance and supervision.</li><li>
Documenting assessments, care plans, interventions, and all other activity related to coordinating the care of case-managed members.</li></ul><p></p><p><b>
Additional Responsibilities</b></p><ul><li>
Maintain client privacy, safety, confidentiality, and advocacy while adhering to ethical, legal, regulatory and accreditation standards.</li><li>
Maintain department procedure/policy standards with regard to turnaround time, etc.</li><li>
Support the interdisciplinary team approach to ensure effective resource utilization, as well as quality and cost-effective outcomes.</li><li>
Coordinate internal and external resources for the individual member.</li><li>
Maintain and update a community resource database.</li><li>
Document all case management activities in the HPMG case management online system.</li><li>
Utilize existing reports and systems to identify and monitor utilization resource patterns and facilitate needed care coordination in order to support Quality Improvement.</li><li>
Refer to various departments for supportive interventions, i.e., Health Education, Quality Management, Contracting, Provider Services, Client Data Management, TPL, COB, etc.</li><li>
Issue letters of explanation in accordance with department policy.</li><li>
Support Medical Management Team, Authorization Review, Clinical Initiatives, and Provider Education.</li><li>
Attend and participate in in service programs and conferences that support practice of case management.</li><li>
Perform other duties as assigned.</li></ul><p></p><p><b>
Required Experience</b></p><ul><li>
Minimum 3 &ndash; 5 years of experience required</li><li>
Minimum three years clinical nursing experience in an area such as medical surgical, critical care, home health or skilled nursing, and;</li><li>
Two years of experience in case management, utilization management, discharge planning and or quality improvement in a managed care setting</li><li>
Experience with managed care delivery including IPA networks and Medicare.</li><li>
Optimum organizational skills with ability to meet both expected and unexpected time frames.</li><li>
Excellent verbal and written communication skills.</li><li>
Ability to coordinate effectively with a variety of customers including members, providers, office staff, health plans, internal department, community resources, and peers.</li><li>
Ability to work independently with self-initiative and discipline.</li><li>
Knowledge of ICD-10 and or CPT coding.</li><li>
Working knowledge of personal computers.</li></ul><p></p><p><b>
Required Education</b></p><ul><li>
A.S. degree</li><li>
Unrestricted California Registered Nurse licensure; certification in case management preferred.</li></ul><p></p><p><b>
Additional Information</b></p><p>
Salary: $100,000 - $123,000 Annual</p><p></p><p><b>
Hill Physicians is an Equal Opportunity Employer</b></p></div>

Case Manager - 26-44

Case Manager - 26-43

Enlyte

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Glendale, CA</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> 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.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC).
</li></ul></li><li><b>Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li><li><b>
Transportation: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $95,000 - $100,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AV1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

Medical Field Case Manager

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in th</b><b>e Albuquerque, New Mexico </b><b>area due to regular local travel for in-person patient appointments.</b></div><div><b>
Bilingual (English/Spanish) Required.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> 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.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $73,000 - $83,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><p>#LI-AC1</p><div></div><div><br>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

Bilingual Field Case Manager

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Baltimore, MD</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> 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.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $79,000 - $90,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AC1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Lubbock, TX</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div><b>
Bilingual (English/Spanish) Required.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> 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.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $68,000 - $75,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AC1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

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