Case Manager RN Specialist

3 weeks ago


Royal Oak, Michigan, United States Horizon Case Management Corp Full time
Job Overview

Hired as a Clinical Case Manager with Horizon Case Management Corp, you will play a pivotal role in delivering top-notch patient care and advocacy services. This challenging yet rewarding position calls for an experienced Registered Nurse to oversee the treatment of claimants alongside workers' compensation and auto insurance adjusters.

Key Responsibilities
  1. Treatment Coordination: Obtain and review patient clinical status and history to determine the causal nature of symptoms related to reported work injuries, ensuring timely and appropriate treatment planning.
  2. Medical Necessity Evaluation: Determine the medical necessity and reasonableness of proposed and ongoing treatments, facilitating informed decision-making.
  3. Communication and Correspondence: Formulate all necessary internal and external correspondence to research and resolve case disputes and inquiries, fostering effective communication among stakeholders.
Requirements and Qualifications
  • Licensure and Certification: Active and unrestricted Registered Nurse license, Bachelor's degree in Nursing (BSN) preferred, and Certified Case Management (CCM) certification or obtain within 2 years of employment.
  • Experience and Skills: Three years of active patient or clinical care experience, excellent oral and written communication skills, customer service expertise, and proficiency in Microsoft Suite.
  • Additional Requirements: Ability to work Monday-Friday between 8am-5pm, travel 50% of the time to meet clients at their doctor appointments, and possess highly effective communications skills in English.

The estimated annual salary for this position is approximately $75,000-$90,000 depending on location and experience. As a valued member of our team, you will enjoy a competitive benefits package and opportunities for growth and development in a dynamic healthcare environment.



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