Job Description

About TRIUNE Health Group

TRIUNE Health Group is a nationally recognized managed healthcare company with over 35 years of experience. As a mission-driven, second-generation family-owned business, we are dedicated to improving lives by reducing the impact of injuries, enhancing health and wellness, and lowering healthcare and workers' compensation costs.

At TRIUNE, we believe that every team member is essential to our success. We foster a supportive and collaborative environment where employees are valued, empowered, and provided with the tools they need to thrive—both professionally and personally.

Why Join TRIUNE Health Group as a Nurse Case Manager?

• Be part of a well-established, family-owned company that prioritizes people over profits.
• Experience our culture of People Helping People , where every team member is treated with dignity and respect.
• Enjoy the stability, support, and resources needed to succeed while maintaining a healthy work-life balance.

Perks & Benefits:

• Generous Time Off: 20 days of vacation plus 8.5 paid holidays
• Retirement Savings: 401(k) match to help you plan for the future
• Comprehensive Insurance: Medical, dental, and vision coverage
• Disability Coverage: Short-Term (STD) and Long-Term Disability (LTD) insurance
• Employee Support: Employee Assistance and Referral Program
• Work-from-Home Essentials: Home office equipment, including a laptop and desktop monitor
• Travel Perks: Mileage and travel reimbursement

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

I. Summary of Position :

The Nurse Case Manager coordinates resources and supports individuals who have sustained work-related injuries through assessment, care coordination, advocacy, and communication with healthcare providers, employers, payers, and other stakeholders. The role focuses on facilitating appropriate medical treatment, promoting recovery, and supporting safe and timely return-to-work outcomes. This position is ideal for a registered nurse seeking to transition into case management and develop expertise through training, mentorship, and hands-on experience.

II. Essential Duties and Responsibilities :

• Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer, and the referral source.
• Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation, and outcome of an individual's progress.
• Assist in evaluating treatment plans for appropriateness, medical necessity, and cost-effectiveness under the guidance of experienced case management professionals.
• Facilitate care, such as negotiating and coordinating the delivery of durable medical equipment and home health services, ensuring clear communication.
• Participate in evaluating rehabilitation and community resources to support patient recovery and return-to-work goals.
• Communicate medical information clearly and compassionately to patients and families.
• Stay current with medical terminology and the federal and state laws related to health care, Workers' Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
• Utilize technology (computer, cell phone, fax, and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPAA.
• Research medical and community resources for individuals with catastrophic or chronic diagnoses, such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, and burns, ensuring accessibility for individuals.
• Possess a valid driver's license with the ability to travel 90% of the time.
• Perform other duties as assigned.

Additional Essential Duty (HIPAA and Workspace Requirements)

• Maintain a dedicated, secure workspace that protects the confidentiality of HIPAA-protected information and complies with company privacy and security standards. Ensure printed documents containing protected health information are stored securely and disposed of appropriately in accordance with HIPAA requirements and company policies.

III. Job Qualifications :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills and Abilities :

• Demonstrated ability to work independently while seeking guidance when needed.
• Strong critical thinking and problem-solving skills.
• Excellent interpersonal and communication skills.
• Desire to learn and grow within the field of case management.
• Excellent verbal and written communication skills, including the ability to interact effectively with patients, customers, and fellow employees via phone, email, in-person, and formal presentations.
• Methodical in accomplishing job-related goals.
• Strong analytical and organizational skills, including the ability to multitask with attention to detail.
• In-depth knowledge of multi-software packages, notably Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and the Internet.
• Maintain a friendly, professional attitude at all times.
• Exercise initiative and be solution-oriented, while keeping management up-to-date on current situations or opportunities.
• Dependability and adaptability.

Education and Experience :

• Graduate of an accredited school of nursing.
• Current RN licensure in the state of operation.
• Fluency in English (speaking, reading, and writing).
• One or more years of nursing experience preferred. New graduates with strong clinical rotations and demonstrated interest in case management may also be considered.
• Experience in medical-surgical, rehabilitation, home health, occupational health, emergency, or acute care settings is preferred but not required.
• Case management experience is not required; training will be provided.
• CCM certification is not required but may be pursued after employment.

Certificates, Licenses, Registrations :

While not mandatory, individuals with one or a combination of the following certifications are preferred: COHN, COHN-S, and CDMS.

IV. Physical Demands :

This position requires a combination of computer-based work and field activities. Employees must be able to regularly operate standard office equipment including computers, keyboards, phones, printers, and mobile devices. The role requires prolonged periods of sitting, typing, and telephone communication, as well as frequent standing, walking, driving, and traveling to attend appointments, meetings, and field visits. Employees must be able to enter healthcare facilities and other locations as required to perform case management services.

The position requires the ability to communicate effectively, maintain sustained concentration, and perform repetitive hand and wrist movements associated with computer and keyboard use. Employees may occasionally lift, carry, or transport lightweight work materials, such as laptops, files, and office supplies, generally weighing no more than 10 pounds.

The base salary range/hourly rate listed is dependent on job-related, non-discriminatory factors such as experience, education, and skills. This position is also eligible for incentive compensation awards.

You may be eligible for the following competitive benefits: medical, dental, vision, life, accident & disability, short and long-term disability, paid holidays, paid time off and 401 (k).

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