🚨 Now Hiring: RN Case Manager – Tampa, FL Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates …
Skills: Case management, Registered nurse, Workers' compensation, Medical case management, Clinical experience
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$54k–$98k/yr
Full-time
associate degree, bachelor degree, professional certificate
Medical insurance, Dental insurance, Vision insurance, Prescription drugs, HSA account, HRA account
Posted 9d ago
~40 hrs/week
Responsibilities
Provide effective medical case management services in compliance with URAC, CMSA, and Broadspire standards. Support patients receiving benefits across various insurance lines including Workers' Compensation, Group Health, and Disability.
Requirements
Requires an RN degree and an active state nursing license in good standing. Candidates must have 1-3 years of clinical experience and possess or be willing to obtain national certification.
Full job description
🚨 Now Hiring: RN Case Manager – Tampa, FL Region 🚨
💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement
We’re looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification required (CCM, CRC, COHN, CRRN) ✨ Workers’ Comp Case Management experience a plus
✅ Your Impact: You’ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You’ll support patients/employees receiving benefits under insurance lines including Workers’ Compensation, Group Health, Liability, Disability, and Care Management.
This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
👉 Apply today and make an impact in the community!
Responsibilities
Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.
Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.
Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.
May perform job site evaluations/summaries to facilitate case management process.
Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians.
Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.
May obtain records from the branch claims office.
May review files for claims adjusters and supervisors for appropriate referral for case management services.
May meet with employers to review active files.
Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.
Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.
May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.
Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.
Reviews cases with supervisor monthly to evaluate files and obtain directions.
Upholds the Crawford and Company Code of Business Conduct at all times.
Demonstrates excellent customer service, and respect for customers, co-workers, and management.
Independently approaches problem solving by appropriate use of research and resources.
May perform other related duties as assigned.
Qualifications
Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.
Minimum of 1-3 years diverse clinical experience and one of the below:
Certification as a case manager from the URAC-approved list of certifications (preferred);
A registered nurse (RN) license.
Must be compliant with state requirements regarding national certifications.
General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
Excellent analytical and customer service skills to facilitate the resolution of case management problems.
Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.
Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.
Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes.
Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously.
Demonstrated leadership ability with a basic understanding of supervisory and management principles.
Active RN home state licensure in good standing without restrictions with the State Board of Nursing.
Must meet specific requirements to provide medical case management services.
Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months.
National certification must be obtained in order to reach Senior Medical Case Management status.
Travel may entail approximately 70% of work time.
Must maintain a valid driver's license in state of residence.
#LI-RG1
Why Crawford?
Because a claim is more than a number - it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer a comprehensive Total Rewards package to our employees to assist with their financial, health/wellness, continuing education/training and other needs:
Competitive base pay
- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate’s previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.
Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include:
- Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program
*The above information highlights some of the benefits currently available to eligible full-time employees.
Training programs that promote continuous learning and career progression while enhancing job performance.
Sustainability programs that give back to the communities in which we live and work.
A culture of respect, collaboration, entrepreneurial spirit and inclusion.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.
Based in Atlanta, GA
Crawford & Company(R) (www.crawco.com) is the world's largest publicly listed independent provider of claims management and outsourcing solutions to carriers, brokers and corporates, with an expansive global network serving clients in more than 70 countries. The company’s shares are traded on the NYSE under the symbols CRD-A and CRD-B.
Offices: 5335 Triangle Pkwy NW, Peachtree Corners, Georgia 30092, US
claims management serviceTPAinland marineworkers compensationand loss adjustingFinanceRisk ManagementInsurTechProfessional ServicesInsurance
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