Workers' Compensation Certified Nurse Case Manager

About the Role

As a Workers' Compensation Certified Nurse Case Manager, you will gather relevant information to assist in the investigation and evaluation of workers’ compensation claims through interviews, verbal or written communications, and medical records. You will help ensure injured parties receive appropriate treatment directly related to their compensable injury.

Responsibilities

• Attend medical appointments with injured employees.
• Communicate in person and by telephone with patients, medical providers, attorneys, and insurance carriers to provide ongoing case management.
• Collaborate with claim handlers/adjusters to ensure injured parties are on an appropriate treatment plan and manage medical treatment to resolution.
• Participate in periodic claim reviews.
• Work tactfully and professionally to gain trust and cooperation, exchanging ideas and information to solve disputes or make decisions.
• Evaluate treatment or return-to-work plans within established protocols.
• Interact with Occupational Health Services (OHS) and Environmental Safety & Health (ES&H) to obtain or clarify clinical information and participate in in-house case reviews.
• Maintain high standards of file documentation, ensuring attention to detail, file accuracy, and timely reports, responses, and case updates.
• Provide comprehensive medical case management oversight of workers’ compensation claims.
• Advocate for appropriate services and treatment to attain best practices standards, maximum medical improvement, and successful return-to-work.
• Communicate with employees, line management, OHS, OSHA recordkeeping, benefits, internal and external counsel, external providers, and others to ensure understanding and cooperation with treatment plans and return-to-work goals.
• Maintain required continuing education as outlined by CCM, TN Bureau of Workers' Compensation, and CNS.

Requirements

• Bachelor’s degree.
• Minimum 7 years of relevant experience as a workers’ compensation nurse case manager (typical experience ranges from 10 to 15 years).
• RN with current state license required.
• CCM certification required.

Preferred Qualifications

• Knowledge of and working familiarity with the Official Disability Guidelines (ODG).
• Knowledge of and working familiarity with the MD Guidelines.
• Documentation and calculation of cost savings per case.
• Strong problem-solving and analytical skills.
• Excellent interpersonal, oral, and written communication skills.
• Proficiency in Word and Excel.
• Ability to interface with treating physicians, division managers, OHS staff, and employees.
• Excellent organization skills.

What You Can Expect

• Meaningful work and unique opportunities supporting missions vital to national and global security.
• Top-notch, dedicated colleagues.
• A stable organization with generous pay and benefits.
• Career advancement and professional development programs.
• Work-life balance fostered through flexible work options and wellness initiatives.

Benefits

• Medical, prescription drug, vision, and dental plans.
• Employer-matched 401(k) savings plan.
• Disability coverage.
• Education reimbursement.
• Onsite workout facilities and healthy cafeteria options.

Notes

Requires a Q clearance; all qualified candidates will be considered regardless of current clearance status. The ability to obtain and maintain a Department of Energy Q clearance is required. This position may require entry into Material Access Areas (MAA) and participation in the Human Reliability Program (10 C.F.R. Part 712), which includes a DOE counterintelligence evaluation and may include a counterintelligence-scope polygraph examination. This position may also be categorized as a “designated position” under 10 C.F.R. Part 709, requiring a counterintelligence evaluation and polygraph examination. CNS is a drug-free workplace; candidates accepting a job offer will undergo a pre-placement physical, drug screening, and background investigation. U.S. citizenship is required for security clearance applicants. Employees may be subject to random drug testing without advance notification.