# TCM/FCM Hybrid Nurse Case Manager

> Rising Medical Solutions · United States (Remote) · Full-time · Posted 2026-11-02

**Workplace:** remote

**Department:** 3335 TCM

## Description

**As our Nurse Case Manager, you will coordinate care for injured or disabled individuals, including high-risk, high-cost, and complex cases. The role applies professional nursing judgment and case management principles to assess needs, facilitate appropriate treatment, monitor progress, support functional recovery and return-to-work goals, and promote quality, cost-effective outcomes through collaboration with clients, patients, employers, providers, attorneys, and other stakeholders.**

_**In this job, you will:**_

-   Maintain a mix caseload of field and/or telephonic case management files. Typical caseload of 30-40 cases.
-   Establish collaborative relationships and serve as an intermediary among clients, injured or disabled individuals, employers, providers, attorneys, and other involved parties.
-   Manage a caseload of high-risk, high-cost, and complex cases by assessing clinical, functional, psychosocial, and vocational needs.
-   Assess, coordinate, implement, monitor, and evaluate individualized care plans using principles of medical necessity, appropriateness of care, case management, and managed care.
-   Promote quality, cost-effective care across the health care continuum to support optimal function and safe, timely return to work when appropriate.
-   Assess injury severity, extent of disability, treatment plans, functional abilities, and physical job requirements to develop return-to-work strategies and help manage future medical exposure.
-   Track and report case management activity and maintain organized, timely, and accurate clinical documentation of interactions, interventions, barriers, outcomes, and communications.
-   Respond to written and telephonic inquiries regarding case status and document relevant case information in Rising systems and client claims systems, when applicable.
-   Adhere to applicable state, national, accreditation, departmental, and client-specific quality standards, guidelines, policies, procedures, and reporting requirements.
-   Escalate potential clinical, operational, service, or compliance concerns to the appropriate supervisor as they become evident.
-   Assist with URAC accreditation activities and the maintenance of related policies and procedures.
-   Provide professional nursing insight to Rising Medical Bill Analysis and other internal teams, as requested.

## Requirements

-   Current, active, unrestricted RN license in primary residence state and preferably in a compact state
-   California RN license a plus
-   Full Time – 9:00am CST to 5:30pm CST, with the ability to flex time based on the jurisdiction
-   Strong computer skills required – Microsoft Suite (Outlook, Excel, Word, etc.)
-   3-5 years of case management experience with 1-2 years of specific worker’s compensation NCM experience

-   Experience with Workers’ Compensation, liability, or disability claims
-   Medical bill review experience with Workers’ Compensation, Auto, or Health Insurance carriers is preferred
-   The ability to maintain confidentiality of all information, policies, and procedures
-   The ability to set priorities and work both autonomously and as part of a team
-   Demonstrated sensitivity to culturally diverse people and situations
-   Well-developed time management, organization, and prioritization skills
-   Knowledge of utilization management, case management, and healthcare provided throughout the health continuum
-   Excellent oral and written communication skills with a heavy focus on customer-service
-   The ability to gather data, compile information, and prepare summary reports
-   Strong interpersonal and conflict resolution skills
-   Experience in a fast-paced, multi-faceted environment
-   Demonstrated persistence and attention to detail
-   The ability to stay calm during stressful situations
-   Having your CCM, and/or any other insurance/workers’ compensation certifications is a huge plus!
-   Professional Nursing degree (ASN, BSN)

## Benefits

-   Competitive base salary, profit sharing, 401k matching, generous time off, and career growth opportunities
-   A relaxed, yet upbeat, work environment
-   Rising was named a Top Workplace in the healthcare industry for 2023! Check out our profile here: [Rising Medical Solutions, Inc Profile (topworkplaces.com)](https://topworkplaces.com/company/rising-medical-solutions/)
-   We're on YouTube! Check out our culture at: [http://www.youtube.com/user/RisingMedical](http://www.youtube.com/user/RisingMedical)
-   Want to see more? Check out our:

-   Facebook: [https://www.facebook.com/RisingMedicalSolutions](https://www.facebook.com/RisingMedicalSolutions)
-   LinkedIn: [http://www.linkedin.com/company/rising-medical-sol...](http://www.linkedin.com/company/rising-medical-solutions)
-   Glassdoor: [http://www.glassdoor.com/Overview/Working-at-Rising-Medical-Solutions-](http://www.glassdoor.com/Overview/Working-at-Rising-Medical-Solutions-) EI\_IE322608.11,35.htm pages

If you are ready to join a team of professionals dedicated to making a difference and making lives better, please apply today!

## Apply

[Apply at Rising Medical Solutions](https://apply.workable.com/rising-medical-solutions-1/j/FB7C458781/apply)

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