Job Description

Join to apply for the Telephonic Nurse Case Manager (Remote) role at Berkley Medical Management Solutions (a Berkley Company) . Boston, MA Company Details BMMS provides a different kind of managed‑care service for W.R. Berkley Corporation. We focus on an injured worker’s successful and speedy return to work, benefiting both individuals and Berkley’s insurance operating units. Founded in 2014, BMMS combines solid clinical practices, proven return‑to‑work strategies, and robust software into a single system for seamless management of workers’ compensation cases. Responsibilities Coordinate and implement medical case management to facilitate case closure. Communicate timely and thoroughly with employers, adjusters, and injured workers. Assess appropriate utilization of medical treatment and services, ensuring cost‑effective quality care. Review and analyze medical records and data to ensure appropriate case management processes and provide recommendations to achieve case progress and closure. Manage assigned caseloads, varying in number, territory, and state jurisdiction. Acquire and maintain nursing licensure for all jurisdictions as required. Coordinate services including home services, durable medical equipment, IMEs, admissions, discharges, and vocational services, evaluating cost effectiveness and quality. Document activities and case progress using appropriate methods and tools, following best practices for quality improvement. Review job analysis/job description with providers to coordinate and implement disability case management, including job analysis with employers to facilitate return to work. Engage and participate in special projects assigned by case management leadership. Occasionally attend on‑site meetings and professional programs. Foster a teamwork environment. Maintain and update evidence‑based medical guidelines (Official Disability Guidelines, MD Guidelines, and required state regulations) in reference to the injured worker treatment plan and work status. Obtain and maintain applicable state certifications and/or licensures where duties are performed. Obtain case management professional certification (CCM) within 2 years of hire. Qualifications Minimum 2 years of experience in workers’ compensation insurance and medical case management (preferred). Minimum of 4 years of medical/surgical clinical experience (required). Strong communication skills, professionalism, flexibility, and adaptability. Working knowledge of medical and vocational resources available to the workers’ compensation industry. Self‑motivation and the ability to perform case management duties independently. Computer and technology skills. Fluency in both Spanish and English (plus). Education Graduate of an accredited school of nursing and current RN license. RN compact license preferred; CCM preferred; Bachelor of Nursing preferred. Salary and Benefits Base salary range: $80,000 - $88,000. Benefits include Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k), and Profit‑Sharing plans. The Company is an equal employment opportunity employer. #J-18808-Ljbffr Berkley Medical Management Solutions (a Berkley Company)

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