* Great Work Life Balance!
* Quarterly Bonus Program!
* Free CEUs for licenses and certificates
* License and national certification reimbursement
This is a work-from-home position requiring local travel within the McAllen, TX region for field case management.
Minimum Requirements:
1. RN degree required
2. Bilingual RN preferred
3. National Certifications such as CCM, CRC, COHN, CRRC preferred
4. Prior Workers' Compensation Case Management experience preferred
Job Responsibilities:
1. Provide quality case management services in a cost-effective manner, adhering to URAC and CMSA standards.
2. Review case records, analyze data, evaluate medical and vocational status, and define client needs.
3. Meet or surpass productivity, quality, and time management standards with minimal supervision.
4. Coordinate return-to-work processes by establishing relationships with injured workers, physicians, and employers.
5. Assist in reviewing reports, conducting field visits, and preparing evaluation reports.
6. Manage cases across multiple service lines, particularly experienced in catastrophic cases and 2-3 other types.
7. Communicate with insurance adjusters and other parties involved in the case.
8. Travel approximately 70% of the time to various locations to facilitate case resolution.
9. Maintain compliance with company policies and uphold customer service excellence.
10. Perform related duties as assigned.
Qualifications:
1. Bachelor's Degree in a health-related field preferred; associates or diploma accepted.
2. At least three years of Workers' Compensation case management experience.
3. Strong communication skills and understanding of jurisdictional WC statutes.
4. Ability to handle complex cases independently.
5. Active RN license in the home state and at least one URAC-recognized certification.
6. Must be able to travel and maintain a valid driver's license.
Additional information about company culture, benefits, and equal opportunity employment policies are included, but should be summarized more concisely to focus on the essential job details for clarity and professionalism.
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