Nurse Case Manager

Job Duties

About the Role:

At SFM, doing the right thing guides everything we do and gives our employees the chance to make a real difference in people’s lives. As a Nurse Case Manager, you will serve as a medical resource and educator, helping manage workers’ compensation claims. Working primarily by phone, you will provide high-quality service to injured workers and policyholders, managing the medical side of each claim and promoting a safe, timely return to work. You will partner with claims representatives as part of a multidisciplinary Business Team, using your medical expertise to help resolve medical and claim issues in a cost-effective way. You will also promote effective case management that follows medical best practice guidelines and state laws and regulations. Delivering excellent customer service to everyone involved in the claims process is central to this role and to SFM’s mission. Apply today to learn why our employees make SFM their long-term employer. The ideal candidate lives in Minnesota, in or near the Twin Cities area. Candidates with occupational health experience are encouraged to apply.

What You’ll Do:

1. Provides telephonic medical case management for workers’ compensation claims, including assessment, care planning, and coordination of services to facilitate return to work and achieve end of healing (EOH) or maximum medical improvement (MMI) in a timely, high-quality, and cost-effective manner.
2. Meets with injured workers, policyholders, and medical providers, in person or virtually, to support the best possible outcomes. Documents initial and ongoing assessments in the claim file so internal customers stay informed of case management and return-to-work progress, supporting timely claim closure.
3. Utilizes effective and proactive return-to-work strategies by working with providers and policyholders to establish a plan using guidelines, medical data, resources, and functional abilities of an injured worker.
4. Provides education and medical treatment parameter information regarding general healing, injury specific health information, and disability duration to internal and external customers to facilitate medical recovery, function and return to work using appropriate state and national resources, while following best practices.
5. Provides clinical guidance and recommendations to the claims team on the appropriateness and timing of medical treatment, cost containment, and return-to-work strategies to bring claims to a successful and timely conclusion. Identifies and coordinates appropriate resources, including physician advisor reviews, second opinions, IMEs, ergonomic evaluations, job analyses, discharge planning, DME, and home health services, and participates in multidisciplinary claim discussions as needed.

Provides premier customer service to all customers and complies with customer service standards. Responds promptly to resolve complaints or problems

Minimum Education Required

• Associate’s Degree (Bachelor’s Degree Preferred) with current RN licensure in the state hired; multi-state licensure preferred.
• Two years of relevant experience such as, Case Management, Physical Rehabilitation, or Occupational Health.
• Worker’s Compensation or casualty insurance experience preferred.
• Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS) or Certified Rehabilitation Registered Nurse (CRRN) designations preferred.
• Five years of clinical experience preferred
• Ability to evaluate ongoing treatment and return-to-work potential within established protocols and make adjustments to case management strategies as warranted.
• Strong knowledge of medical treatment protocols and physician advisor utilization
• Effective organizational skills including the ability to manage multiple projects and work with minimal direction.
• Excellent customer service and interpersonal skills

Minimum Experience Required

• Associate’s Degree (Bachelor’s Degree Preferred) with current RN licensure in the state hired; multi-state licensure preferred.
• Two years of relevant experience such as, Case Management, Physical Rehabilitation, or Occupational Health.
• Worker’s Compensation or casualty insurance experience preferred.
• Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS) or Certified Rehabilitation Registered Nurse (CRRN) designations preferred.
• Five years of clinical experience preferred
• Ability to evaluate ongoing treatment and return-to-work potential within established protocols and make adjustments to case management strategies as warranted.
• Strong knowledge of medical treatment protocols and physician advisor utilization
• Effective organizational skills including the ability to manage multiple projects and work with minimal direction.
• Excellent customer service and interpersonal skills

Shift

First (Day)

Number of Openings

1

Public Transportation Accessible

No

Physical Required

No

Drug Test Required

No

Compensation

$74,500.00 - $104,295.00 / Annually

Postal Code

55431

Job Type

Full Time

Place of Work

Remote

Requisition ID

100008

Job Benefits

Why You’ll Love Working Here

We want your work life to feel balanced, rewarding, and supported. Here are just a few of the benefits SFM offers:

• Comprehensive medical, dental, and vision coverage (plus HSA/FSA options).
• Significant Cash Benefit if You Opt Out of Our Health Plan
• Flexible hybrid work environment.
• 401(k) with both Traditional and Roth options + company match.
• Contributions toward student loan repayment.
• Generous PTO, 9 paid holidays, and paid parental leave.
• Monthly home internet allowance.
• Free life insurance, short-term & long-term disability coverage.
• Incentive bonus opportunities.
• Adoption financial assistance.
• Pet insurance.
• Annual company-wide volunteer day.
• Discounts on gyms, fitness apps, and wellness programs.