The Many Roles of Case Management Nurses

Assessor, planner, facilitator, advocate, educator – these are just a few of the countless roles case management nurses play in their day-to-day duties. While they’re at it, these skilled providers are saving the employer thousands in avoidable healthcare costs, and getting employees back to work sooner, safer, and with less lost time. 

Let’s take a look at four key roles you might not know that case management nurses play at your organization. 

Employee Advocate and Educator

When an employee gets injured, case management nurses assist them with navigating the healthcare system with their workers’ compensation or disability claims. Assessing an injured employee’s barriers to return to work, including their unique social determinants of health, can help to optimize recovery and support. Family, mental health, and financial stressors are key areas that a case management nurse can impact using the resources they connect injured workers with. 

These advocates serve as an employee’s voice to ensure they get the restricted work accommodations they need and help track an employee’s progression after an injury until they’re back to full duty work or maximum medical improvement (MMI). By serving as a trusted partner to employees, case management nurses take a huge mental load off an employee who is simultaneously dealing with an injury or illness. 

Workplace Injury Expert

When it comes to the rules and restrictions around workplace injuries, case management nurses are some of the most knowledgeable experts. They use their expertise to ensure employers stay in compliance with all regulations, including ADA, EEOC, workers’ compensation, disability, FMLA absences, and any industry-specific guidelines.  

At the same time, they perform validation of an employee’s medical documentation, review the physical and mental demands of a role, and recommend an absence duration and target return-to-work date after an injury using industry benchmarks and ensuring treatment plan adherence to best practice guidelines. They ensure an injured or ill employee receives high-quality care delivered in a cost-effective manner, bringing immense value to an organization. In doing so, they help organizations avoid unnecessary indirect costs that can occur when employees are unable to properly recover from an injury and return-to-work before it’s safe to do so.  

Employer Advisor

Case management nurses serve in an important, trusted role as they advise employers on navigating on-the-job injuries. They perform timely tracking and reporting on time cases that is required by OSHA and is crucial to employers. They’re also assessing barriers that could prevent an employee from returning to work in a timely manner and partner with onsite employer teams like environmental health and safety to review the physical and mental demands of a job. All of this is done through frequent interaction and planning with an organization’s human resources department, legal team, and third-party administrator (TPA). 

Master Communicator

One of the biggest responsibilities of a case management nurse is communication. They are constantly serving as a liaison between employers, employees, and balancing collaboration with insurance providers and specialists. 

Employers can rely on case managers for regular updates on an injured employee’s status and return-to-work planning. They also communicate with injured employees to help them understand their care plan and any modified capabilities as employees return to the workplace. Clinically, case management nurses participate in clinician-to- clinician discussions to evaluate an employee’s capabilities and potential accommodations as they relate to specific job requirements. All this communication keeps all parties on the same page and ultimately helps employees seamlessly and safely return-to-work after an injury. 

Expert communicator, employee advocate and educator, workplace injury expert, employer advisor – at Premise Health, our case management nurses play each of these roles skillfully. By doing so, they ensure that your employees can get back to work safely by receiving appropriate, cost-effective care that reduces lost time and improves productivity. In doing so, case management nurses contribute to cost savings for organizations by ensuring employees recover and get back to work safely.  

Want to learn more about how a case management nurse can help your occupational health program? Contact us today. 

And if this role sounds like you, check out Premise Health’s career site to view open case manager nurse jobs.