Nurse Case Manager

Nurse Case Manager - Michigan

TRIUNE Health Group – a nationally recognized managed healthcare company with over 35 years of experience. As a mission‑driven, family‑owned business, we are dedicated to improving lives and reducing the impact of injuries and healthcare costs.

• Part of a well‑established, family‑owned company that prioritizes people over profits.
• Culture of People Helping People, treating every team member with dignity and respect.
• Stability, support, and resources for success while maintaining a healthy work‑life balance.

• Generous Time Off: 20 days vacation plus 8.5 paid holidays
• 401(k) match for retirement savings
• Medical, dental, and vision coverage
• Short‑Term and Long‑Term Disability insurance
• Employee Assistance and Referral Program
• Work‑from‑Home essentials: laptop and monitor
• Travel mileage and reimbursement

TRIUNE Health Group is an equal‑opportunity employer and a values‑driven organization. Compensation is competitive and commensurate with experience.

The Nurse Case Manager coordinates resources and provides flexible, cost‑effective options for catastrophically or chronically ill or injured individuals, facilitating quality, individualized holistic treatment goals and timely return to work when appropriate.

• Provide medical case management to individuals through coordination with patients, physicians, other health care providers, employers, and referral sources.
• Utilize case‑management steps (assessment, planning, implementation, evaluation) to chart progress.
• Evaluate treatment plans for appropriateness, medical necessity, and cost‑effectiveness.
• Negotiate and coordinate durable medical equipment, home health services, rehabilitation facilities, transportation, and architectural assessments.
• Communicate medical information clearly and compassionately to patients and families.
• Maintain current knowledge of medical terminology and federal and state laws related to health care, Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
• Use technology (computer, cell phone, fax, scan) to prepare timely reports, complying with safety rules, HIPAA, and regulations.
• Research medical and community resources for individuals with catastrophic or chronic diagnoses (e.g., AIDS, cancer, spinal cord injuries, diabetes, head injuries, burns).
• Possess a valid driver’s license; able to travel ~90% of the time.
• Perform other duties as assigned.

To perform this job successfully, an individual must have the knowledge, skill, and ability listed below. Reasonable accommodations may be made for people with disabilities.

• Proven leadership and initiative.
• Excellent verbal, written, and presentation skills; able to interact with patients, customers, and colleagues via phone, email, in‑person.
• Methodical and analytical; able to multitask with attention to detail.
• Proficient in multi‑software packages:
  Microsoft Office Suite, Internet, etc.
• Friendly, professional attitude at all times.
• Dependable and adaptable.

• Graduate of an accredited school of nursing.
• Current RN licensure in the state of operation.
• Fluency in English (speaking, reading, writing).
• Minimum 3 years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, neurology.
• CCM preferred.

Preferred: COHN, COHN‑S, CDMS; not required.

Physical demands include regular travel and on‑site visits. Reasonable accommodations can be made.

MICHIGAN, $35.00–$38.00 per hour; SENIORITY – Mid‑Senior level;

EMPLOYMENT TYPE

– Full‑time; JOB FUNCTION – Health Care Provider; INDUSTRIES – Wellness & Fitness Services.