Bilingual RN Field Case Manager / Utilization Review – Workers' Comp

CoreCare Medical Management Services is hiring a bilingual (English/Spanish) Registered Nurse as a Field Nurse Case Manager / Utilization Review Nurse covering Baton Rouge and the surrounding area.

This role combines two skill sets: field and telephonic workers' compensation case management, and Utilization Review. You'll work independently in the field and from a home-based office, backed by an experienced Louisiana workers' compensation medical management team.

Applicants must live in or near the Baton Rouge area.

THE ROLE
As a CoreCare Nurse Case Manager, you are an advocate and medical resource for injured workers from injury through return to work. You'll meet face-to-face with injured workers and their providers, keep adjusters and employers informed, and review treatment requests to determine whether they are medically appropriate and consistent with applicable guidelines.

WHAT YOU'LL DO
Case Management
- Provide field and telephonic nurse case management on workers' compensation claims
- Meet with injured workers and medical providers, and attend medical appointments when appropriate
- Communicate with injured workers in both English and Spanish
- Coordinate treatment, diagnostic testing, therapy, specialist referrals and other services
- Identify appropriate medical providers and facilities
- Identify barriers to recovery and help develop and coordinate return-to-work plans
- Keep adjusters, employers, physicians and other involved parties updated
- Prepare timely, accurate case management reports and documentation

Utilization Review
- Review medical records, treatment plans and treatment requests
- Evaluate requested treatment for medical necessity and appropriateness
- Apply treatment guidelines and workers' compensation requirements
- Help ensure medical resources are used appropriately and cost-effectively

WHY CORECARE?
Our nurses are central to everything we do. We believe effective case management takes clinical judgment, clear communication and personal contact with injured workers and their providers.

CoreCare provides a full range of workers' compensation medical management services: nurse case management, catastrophic case management, Utilization Review, vocational rehabilitation, bill review and IME coordination. You'll have the independence of field work with the support of a team that knows Louisiana workers' comp.

HOW TO APPLY
If you're a bilingual RN with workers' compensation case management and Utilization Review experience, we'd like to hear from you. Apply with your resume and tell us about your experience in workers' compensation, field case management and Utilization Review.

CoreCare Medical Management Services is an Equal Opportunity Employer.

REQUIRED
- Current, unrestricted Louisiana Registered Nurse (RN) license
- Bilingual: English and Spanish
- Live in or near Baton Rouge, with the ability to travel throughout the area
- Valid driver's license and reliable transportation
- Reliable high-speed internet for home-based work
- Strong medical record review and clinical assessment skills
- Ability to manage a caseload and priorities independently
- Excellent written and verbal communication skills
- Commitment to confidentiality and HIPAA compliance

PREFERRED
- Utilization Review experience (strongly preferred)
- Workers' compensation nurse case management experience
- Field case management experience
- CCM certification (preferred, not required)