Sr Medical Case Manager

Now Hiring: RN Case Manager - Sioux Falls, SD 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 preferred (CCM, CRC, COHN, CRRC)
✨ 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 Sioux Falls community!


* Bachelor's Degree in a health-related field is preferred.

Associates or diploma in nursing also accepted.


* Three years of Workers' Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity.


* Demonstrated ability to handle complex assignments and ability to work independently is required.


* Effective oral and written communication skills are required.


* Thorough understanding of jurisdictional WC statutes.


* Advanced knowledge to exert positive influence in all areas of case management.


* Advanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned.


* Highly skilled at promoting all managed care products and services internally and externally.


* Active RN home state licensure in good standing without restrictions with the State Board of Nursing.


* Minimum of 1 nationally recognized Certification from the URAC list of approved certifications.


* Must be able to travel as required.


* Individuals who conduct initial clinical review possess an active, professional license or certification:
+ To practice as a health professional in a state or territory of the U.S.; and
+ With a scope of practice that is relevant to the clinical area(s) addressed in the initial clinical review.


* Must maintain a valid driver's license in state of residence.

#LI-RG1


* May assist supervisor/manager in review of reports, staff development.


* Reviews case records and reports, collects and analyzes data, evaluates client's medical and vocational status and defines needs and problems in order to provide proactive case management services.


* Demonstrates ability to meet or surpass administrative requirements, including productivity, time management, quality assessment (QA) standards with a minimum of supervisory intervention.
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