Nurse Case Manager

Title: Nurse Case Manager - Lexington, KY

Location: Lexington, KY

Job Description:

At TRIUNE Health Group we strive to treat everyone with the highest level of respect.  This relates not only to our employees but also to the customers and clients we serve. The individuals who join our team are among the best in the industry in terms of skill and qualifications.  When we hire an individual, we not only look at their skills, but more importantly at their integrity.

Everybody wants to be treated well, with respect, with dignity.  At TRIUNE Health Group, our management team works tirelessly to create a culture where each of our employees are treated as professionals and as people.

Professionals who are interested in excellence, in achieving goals, in growing both individually and professionally, are all encouraged to join our growing company.

Individuals seek out TRIUNE Health Group as a place of employment for a variety of reasons. We appreciate that fact. We know that some are looking for job stability, while others are looking for career development. Some people want a company which will respect and care for them, others seek a company which they can trust.

As a company, TRIUNE Health Group provides service offerings to the multi-faceted aspects of the health care industry. In delivering these services, we help each individual to reach a level of total health: physical, psychological, and spiritual. This is not only a goal for those we serve, but for each employee of TRIUNE Health Group.

We are committed to providing you with the tools, resources, opportunities, and support to help you identify your career goals and develop your skills to pursue your potential. Realizing that individuals have different styles of learning, we offer training and development using various methods, whether it be mentoring or in monthly meetings with Management or Team Leaders. The success of TRIUNE Health Group is directly correlated to the individual success of our people and we are committed to help you succeed.

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 creates flexible, cost-effective options for catastrophically or chronically ill or injured individuals to facilitate quality, individualized, holistic treatment goals, including timely return to work when appropriate.

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.
• Evaluate individual treatment plans for appropriateness, medical necessity, and cost-effectiveness.
• Facilitate care, such as negotiating and coordinating the delivery of durable medical equipment and home health services, ensuring clear communication.
• Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate architectural assessments of patients’ homes when required.
• 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.

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:

• Proven leadership skills.
• 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).
• Three or more years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, and neurology.
• CCM preferred.

Certificates, Licenses, Registrations:

The state board requires one or more or a combination of the following certifications: CCM, CRC, CRRN, LPC, COHN, COHN-S or CDMS.

IV. Physical Demands:

Physical Demands

This position primarily involves sedentary work requiring prolonged periods of sitting, computer use, typing, and telephone communication. Employees must be able to regularly operate standard office equipment including computers, keyboards, phones, and printers.  The position occasionally requires standing, walking, and driving for field visits or meetings, depending on business needs and position assignment.

Reasonable accommodations or modified duties, including telephonic case management, may be available where appropriate.

The role may occasionally require lifting, carrying, or transporting lightweight work materials such as laptops, files, or office supplies generally weighing no more than 10 pounds.

The position requires the ability to communicate effectively, maintain sustained concentration, and perform repetitive hand and wrist movements associated with computer and keyboard use.

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).