Workers Compensation Telephonic Nurse Case Manager

W. R. Berkley Corporation

. Assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers .

Posted 10/30/2026full-timeRemote • Tennessee • United StatesMid-LevelSenior💰 $83,000 - $88,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical case management, including assessment, coordination, and implementation of services to facilitate timely medical care and return-to-work outcomes. Holds relevant nursing licensure and certifications while effectively communicating with stakeholders and managing caseloads.

Highest-signal resume keywords

Medical Case ManagementCalifornia RN LicenseCCM CertificationWorkers Compensation Insurance ExperienceBilingual in Spanish and English

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Record ReviewData AnalysisCost-Effective Care AssessmentUtilization ReviewCase Closure CoordinationVocational Resource KnowledgeQuality Improvement Best PracticesClinical ExperienceHome Services CoordinationDurable Medical Equipment Management

Soft Skills

Strong Communication SkillsProfessionalismFlexibilityAdaptabilitySelf-Motivation

Tools & Technologies

Case Management SoftwareDocumentation ToolsQuality Improvement Tools

Certifications & Qualifications

CCM CertificationCurrent RN LicenseContinuing Education Units

Industry Keywords

Workers CompensationMedical Case ManagementVocational ServicesEvidence-Based Medical GuidelinesState-Regulated Guidelines

About the role

Key responsibilities & impact

Assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers
Coordinate and implement medical case management to facilitate case closure
Communicate with employers, adjusters and injured workers
Assess utilization of medical treatment and services through contact with physicians and other specialists to ensure cost-effective quality care
Review and analyze medical records and assess data to ensure appropriate case management and recommend actions to achieve case progress and closure
Manage assigned caseloads, varying by number, territory and/or state jurisdiction
Acquire and maintain nursing licensure for jurisdictions as business needs require
Coordinate home services, durable medical equipment, IMEs, admissions, discharges and vocational services, evaluating cost-effectiveness and quality
Document activities and case progress using appropriate methods and tools following quality-improvement best practices
Review job analyses/descriptions with providers and employers to coordinate disability case management and return to work
Participate in special projects assigned by case management leadership
Occasionally attend on-site meetings and professional programs
Maintain and update evidence-based medical guidelines and state-regulated guidelines for treatment plans and work status
Obtain and maintain applicable state certifications and/or licensures
Obtain case management professional certification (CCM) within 2 years of hire
Earn continuing education units to maintain certifications and licensures
Foster a teamwork environment

Requirements

What you’ll need

Minimum 2 years of experience in workers compensation insurance and medical case management preferred
Ability to work Pacific Standard Time business hours
California RN license greatly preferred
Minimum of 4 years medical/surgical clinical experience required
Exhibit strong communication skills, professionalism, flexibility and adaptability
Possess working knowledge of medical and vocational resources available to the Workers’ Compensation industry
Demonstrate evidence of self-motivation and the ability to perform case management duties independently
Demonstrate evidence of computer and technology skills
Oral and written fluency in both Spanish and English a plus
Graduate of an accredited school of nursing and possess a current RN license
RN compact license preferred
CCM preferred
Bachelor of Nursing preferred
Domestic U.S. travel required (up to 10% of time)
Sponsorship not Offered for this Role

Benefits

Comp & perks

Health
Dental
Vision
Life
Disability
Wellness
Paid Time Off
401(k)
Profit-Sharing plans
Competitive compensation plan
Robust benefits package for full time regular employees