Case Manager

Telephonic Case Manager - Workers' Compensation

Location: New Jersey (Active NJ License Required)

Job Type: Full-Time

About the Role

As a Telephonic Case Manager, you'll lead the coordination of care for workers' compensation claims involving lost time and extensive medical treatment. You'll serve as the main point of contact among claimants, providers, attorneys, and clients to ensure medical care is appropriate, timely, and well-managed.

Responsibilities

• Conduct telephone interviews and gather clinical and claim-related information from all stakeholders
• Complete three-point contact, direct care into the network, and follow up on treatment status
• Assess provider treatment plans and approve care and diagnostic testing based on HCS protocols
• Act as client liaison for escalations related to medical care, treatment plans, and claims
• Communicate with claimants, providers, and clients to facilitate and monitor treatment
• Identify complex claims and escalate to nurse case manager when necessary

Minimum Qualifications

• Registered Nurse (RN) or Master's degree with LPC, LSW, or LCSW
• Active New Jersey nursing or clinical license
• 2+ years of experience in healthcare, insurance, or workers' compensation case management
• Strong working knowledge of medical terminology and case management philosophy
• Proficient in MS Office (Word, Excel, PowerPoint), Windows environment, intranet, and internet applications
• Excellent typing, data entry, and numeric keypad skills

Skills & Attributes

• Strong analytical and problem-solving abilities
• Excellent communication and organizational skills
• Attention to detail and customer service mindset