Nurse Case Manager

Location:
South Sioux City, NE

Hybrid

Schedule:

3 days in office, 2 days remote upon successful completion of training.

At Great West, we are committed to helping our customers and injured workers achieve the best possible outcomes. As a Nurse Case Manager
, you'll play a critical role in proactively managing the medical treatment and recovery of employees injured on the job. Leveraging your clinical expertise, you'll collaborate with claims professionals, medical providers, employers, and vendor partners to ensure quality care, facilitate return-to-work efforts, and promote cost-effective claim resolution.

This position is ideal for an experienced nurse who enjoys combining clinical knowledge, case management, and collaboration to make a meaningful difference in people's lives.

As a Nurse Case Manager, you will:

• Conduct comprehensive initial and ongoing assessments of injured workers' medical conditions, treatment plans, clinical histories, and functional limitations.
• Develop and implement medical management strategies that support recovery and resolution of workers' compensation claims.
• Coordinate care with healthcare providers, vendors, and claims adjusters to ensure appropriate, evidence-based treatment plans.
• Review treatment recommendations against workers' compensation guidelines and utilization review standards to ensure medical necessity and cost efficiency.
• Facilitate communication among injured workers, medical providers, claims professionals, and other stakeholders regarding treatment progress, prognosis, and work capabilities.
• Evaluate job descriptions and identify modified duty or transitional work opportunities that align with medical restrictions.
• Assist employers with return-to-work planning and accommodation strategies.
• Maintain accurate, timely documentation of case activity, medical records, communications, and treatment milestones.
• Travel to customer locations to educate clients on Great West's nurse case management services and build strong working relationships.
• Provide medical and disability management guidance to claims professionals through training, mentoring, and consultation.
• Assist with the coordination and management of medical vendors and cost containment resources.
• Stay informed on workers' compensation laws, regulations, medical case management best practices, and industry developments.
• Maintain required licenses, certifications, and continuing education requirements.

We're seeking a professional who:

• Has a passion for helping injured workers achieve positive recovery outcomes.
• Demonstrates strong clinical assessment and critical thinking skills.
• Excels at communication, relationship building, and collaboration.
• Can effectively manage multiple cases and priorities in a fast-paced environment.
• Is comfortable working independently while also contributing to a team-oriented culture.
• Possesses strong organizational and documentation skills.
• Is committed to exceptional customer service and professional integrity.

• Graduate of an accredited School of Nursing required.
• Bachelor of Science in Nursing (BSN) preferred.
• Active, unrestricted Registered Nurse (RN) compact license required.
• Minimum of 5-7 years of clinical nursing experience required. Experience in Occupational Health, Emergency Room (ER), Intensive Care Unit (ICU), Orthopedics, Rehabilitation, or similar clinical settings preferred.
• Prior workers' compensation case management experience highly desirable.
• Certified Case Manager (CCM) designation preferred and required to be obtained within two years of hire.
• Ability to travel periodically to customer…