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CategoryHealthcare
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No of Jobs1
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Apply Before09/23/2025
Description
Medical Case Manager
Crawford & Company - Columbus, GA
Job Title: Medical Case Manager
Position: RN Case Manager
Job Type: Remote
Pay:
Shift:
Work Type: Work from Home
Location
Address:
City: Columbus
State: GA
ZIP Code:
Job Responsibilities
- Review case records and reports, collect and analyze data, and evaluate injured worker/disabled individual's medical status.
- Identify needs and obstacles to medical case resolution and RTW by providing proactive case management services.
- Render opinions regarding case costs, treatment plans, outcomes, and problem areas, and make recommendations to facilitate case management goals, including RTW.
- Demonstrate ability to meet administrative requirements, including productivity, time management, and QA standards, with minimal supervisory intervention.
- Perform job site evaluations/summaries to facilitate the case management process.
- Establish a professional working relationship with the injured worker/disabled individual, physician, and employer to facilitate timely return to work date.
- Coordinate RTW with injured worker, employer, and physicians.
- Maintain contact and communicate with claims adjusters to apprise them of case activity and direction or secure authorization for services.
- Obtain records from the branch claims office and review files for claims adjusters and supervisors for appropriate referrals.
- Review active files with employers.
- Make referrals for Peer reviews and IMEs by obtaining and delivering medical records and notifying injured workers/disabled individuals.
- Utilize clinical expertise and medical resources to interpret medical records and test results and provide assessment accordingly.
- Spend approximately 70% of work time traveling to homes, health care providers, job sites, and various offices as required for case facilitation.
- Meet monthly production and QA requirements to ensure a quality product.
- Review cases with supervisor monthly to evaluate files and obtain directions.
- Uphold the Crawford and Company Code of Business Conduct.
- Demonstrate excellent customer service and respect for customers, co-workers, and management.
- Independently approach problem-solving using appropriate research and resources.
- Perform other related duties as assigned.
Required Skills
Core Skills
- RN Degree
- National Certification (CCM, CRC, COHN, CRRC)
- Prior Workers Compensation Case Management experience
- Excellent oral and written communication skills
- Excellent analytical and customer service skills
- Basic computer skills including working knowledge of Microsoft Office products
- Demonstrated ability to establish collaborative relationships
- Excellent organizational skills
Preferred Skills
- Certification as a case manager from an URAC-approved list of certifications
- BSN Degree
Requirements
Experience: Minimum of 1-3 years diverse clinical experience.
Education: Associate's degree required; BSN Degree preferred.
License & Certification:
- Active RN home state licensure in good standing
- National Certification (must be planned within 36 months if not already obtained)
Schedule:
- Travel may entail approximately 70% of work time.
COVID-19 Requirements: This position may require you to be fully vaccinated for COVID-19.
Benefits
- Quarterly Bonus Program
- Free CEUs for licenses and certificates
- License and national certification reimbursement
- Benefits programs that empower financial, physical, and mental wellness
- Training programs that promote continuous learning and career progression
Supplemental Pay
- Not specified
Special Notes
- Crawford & Company participates in E-Verify and is an Equal Opportunity Employer.
- Diversity and inclusion values are emphasized in the workplace.
Facility Details
Name: Crawford & Company
Description: Crawford & Company helps to restore lives and communities one claim at a time.
Specialties:
- Insurance
- Claims Management
- Healthcare
Mission: To pioneer new solutions for the industries and customers we serve.
Job Info
Discipline:
Department:
Status:
Sourcing
Duration:
Experience:
Career Level:
No of Jobs:
1
Apply Before:
09/23/2025
Posted:
06/23/2025
