Duties: With a high level of medical expertise and under minimal supervision provide strategic case management for long term TTD, PTD and PPD claims with complex medical issues to establish medical stability or claims closure. Conduct intensive files reviews, develop and implement long range action plan strategies that either lead to claims closure or medical stability. May serve as a medical resource for injured employees relating to diagnosis, treatment plan, or medical services. Research and analyze provider treatment plans with evidence-based best practices and negotiate an acceptable course of action with multiple providers. Analyze medical claims management issues with other claims professionals through communication, coordination and facilitation of information, and negotiate appropriate treatment plans with medical providers. Evaluate on-going services provided to ensure provider compliance with negotiated treatment plan and medical care is effective. Occasional travel with some overnight stays required.Core Competency: Customer Service, Initiative & Accountability, Job Knowledge, Communication, and Decision Making.Education and Experience: Requires current RN, APRN or PA licensure and 4 years clinical experience and 1 year medical case management experience. Workers Compensation experience preferred. Masters degree in a related field, Certified Case Manager (CCM), Certified Rehabilitation Registered Nurse (CRRN), Certified Occupational Health Nurse (COHN), Certification in Case Management, Community Health, Home Health, or Medical-Surgical Nursing (RN,C), Certified Managed Care Nurse (CMCN) is preferred.