Insurance Case Manager Jobs in Mobile, AL (NOW HIRING)

About Us: We are passionate about making a difference in the world of workers' compensation. Our team is dedicated to providing exceptional case management services to ensure injured workers receive the care and support they need to return to work safely and efficiently. We believe in the power of purpose and passion, and we are looking for a Field Case Manager who shares our commitment to making a positive impact.

Purpose: At Custom Case Management; VONA Company, we believe in the power of purpose and passion in everything we do. Our Field Case Manager plays a critical role in facilitating and coordinating the rehabilitation needs of injured workers in a timely and cost-effective manner. This position requires the consistent use of clinical expertise, independent judgment, and discretion to promote optimal outcomes, advocate for recovery, and support the physical and emotional well-being of our clients. The Field Case Manager utilizes their advanced knowledge and professional expertise to independently assess, plan, and implement strategies that significantly influence the return-to-work process. This role requires discretion and independent judgment in evaluating complex cases, coordinating multidisciplinary resources, and determining the most effective interventions to support recovery and reintegration. 

Core Responsibilities:

• Independently assess the injured worker’s medical condition and develop a coordinated treatment plan in collaboration with healthcare providers.
• Cultivates and maintains strategic business relationships to generate ongoing referral opportunities, emphasizing proactive engagement and value-driven collaboration beyond the scope of standard clinical directives.
• Collaborates on individualized care plans for clients, aligning with organizational policies and regulatory standards.
• Coordinates services across departments and external providers, ensuring compliance with healthcare regulations and cost-efficiency goals.
• Analyzes client needs and recommends strategic interventions that impact overall case outcomes and resource allocation. 
• Exercises independent judgment in prioritizing client needs, selecting service providers, and adjusting care plans based on evolving circumstances.
• Collaborate with the leadership, providing insights that influence policy and procedural updates. 
• Coordinate with executive-level personnel on complex cases.
• Participate in or attend industry conferences, account in-services, and/or account business meetings to provide education on the role of a case manager as needed.
• Maintain timely and professional communication with all stakeholders, including injured workers, medical professionals, employers, and insurance representatives.
• Coordinate and attend medical appointments as needed to ensure continuity of care and alignment with the treatment plan.
• Collaborate with employers to recommend and implement job duty modifications based on medical restrictions and functional assessments.
• Interpret and explain medical instructions from physicians and therapists to injured workers, ensuring understanding and compliance.
• Serve as a liaison and advocate for the injured worker, providing education and support throughout the recovery and return-to-work process.
• Stay current with developments in medical case management, workers' compensation regulations, and best practices.
• Maintain all required professional licenses and certifications in good standing.
• Prepare and submit detailed monthly progress reports and documentation in accordance with company standards.
• Accurately document time and activities related to case management duties as required by Custom Case Management; A VONA Company.

• Registered Nurse (RN) license required.
• Certified Case Manager (CCM) certification preferred.
• Prior experience in case management required, preferably in workers' compensation or occupational health.
• Strong understanding of medical terminology and clinical practices.
• Demonstrated ability to exercise independent clinical judgment and make decisions that impact case outcomes.
• Experience working in hospital or rehabilitation settings.
• Familiarity with HIPAA regulations and confidentiality standards.
• Multilingual proficiency is a plus.

Why Custom Case Management; A VONA Company: We are driven by a shared purpose: to improve the lives of our clients and provide exceptional care in the Case Management Workers Compensation Industry. We offer a collaborative and supportive work environment where your passion for financial excellence and dedication to making a difference will be valued and rewarded. Join us in our mission to create positive change and be part of a team that truly is making an impact.

VONA is an equal opportunity employer and values diversity in the workplace.