RN, Case Manager

Field-based case management role servicing San Jose, CA and surrounding areas, focusing on quality medical case management for injured workers. Coordinate appropriate care, make recommendations, and professionally communicate with insurance carriers, healthcare providers, ancillary vendors, employers, and attorneys. Drive to and attend medical appointments in-person, complete thorough documentation, and qualify for bonus compensation.

About the role

Provide field-based case management services within the worker's compensation industry by utilizing professional judgment and discretion, applying professional processes, and adhering to Case Management Society of America (CMSA), ISYS, and customer guidelines. Facilitate appropriate qualitative and timely medical care for injured workers through prudent case management strategies, proactive communication, and coordination with all parties to enable optimal recovery outcomes, including return-to-work determination, file progression towards Permanent and Stationary designation, and cost containment.

Responsibilities

• Frequent travel (driving) throughout designated geographical service areas to in-person appointments/visits, with potential overnight or air travel for special occasions, geographies, or coverage purposes.
• Manage cases as assigned, including 'rush' or same-day referrals, and attend medical appointments scheduled during facility hours.
• Autonomously manage assigned caseload, coordinating weekly and daily work activities and schedules for optimal time management and professional prioritization.
• Conduct onsite case management services following CMSA guidelines and ISYS protocols and procedures.
• Coordinate, facilitate, conduct, and complete in-person attendance at physician appointments, hospital visits, case conferences, home visits, and ancillary providers to facilitate timely treatment recommendations.
• Initiate and conduct professional discussions with medical providers regarding diagnosis, treatment, and prognosis.
• Apply case management process, education, and experience to facilitate appropriate and timely treatment and recovery of the injured worker, aiming for maximal recovery and return to work.
• Provide proactive and timely communication, and coordinate collaboration with all parties involved in each case, in-person, by phone, and/or in writing.
• Support the injured worker's progress toward achieving Maximum Medical Improvement and foster realistic and effective return-to-work opportunities by exploring viable options with all involved parties.
• Facilitate timely claim resolution through proactive and professional communications, case-specific research, information analysis, and providing appropriate advice, direction, and action plans to implement treatment and optimize realistic outcomes.

Pay

Compensation range: $120,000.00 to $180,000.00 annually. Includes both biweekly salary and uncapped bonus pay, allowing high earning potential based on performance.

Benefits

• Flexible schedule with the opportunity to adjust work responsibilities to fit personal preferences and workstyle.
• Paid Time Off (PTO) accrued monthly, with the ability to earn bonus PTO rewards annually.
• Comprehensive benefits package including:
  • Tax-deferred retirement program
  • Medical, dental, and vision insurance
  • Ancillary supplement health plans
  • Long-term disability insurance
  • Employee assistance program

About ISYS Case Management

ISYS is an organization dedicated to providing forward-focused care coordination and customer service in the workers' compensation community since 1998. Our mission is to work creatively and intensively to provide case management solutions and positively impact those we serve. Our company culture is built on the following values:

• Always do the right thing
• Deliver excellence in everything we do
• Encourage a "Hug Your Customer" philosophy
• Communicate respectfully and proactively
• Build relationships upon trust
• Give generously
• Pursue growth and learning
• Be honest, authentic, grateful, and humble
• Promote individual and economic liberty
• Embrace the family spirit

Annual employee surveys, team-building activities, and gatherings to acknowledge exceptional performance are part of our culture. ISYS also has a Charitable Activities Committee that promotes employee involvement in the "Pay it Forward" program, focusing on giving back to the communities in which we live and work.