Bilingual Telephonic Case Manager

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, 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.

The Bilingual Telephonic Case Manager (RN) coordinates and manages the medical care of injured or ill individuals entirely over the phone to support safe and timely recovery and return to work. The role requires fluency in both Spanish and English to effectively communicate with patients, providers, and employers, ensuring clear understanding and efficient coordination of services — all while reducing unnecessary costs and optimizing quality outcomes.

Conduct telephonic case management, collaborating with patients, physicians, health care providers, employers, and referral sources in both Spanish and English. Perform assessments, create care plans, monitor progress, and evaluate outcomes via phone and electronic documentation. Review treatment plans for appropriateness, medical necessity, and cost-effectiveness. Coordinate services such as durable medical equipment, therapy, home health, and return-to-work programs, ensuring clear bilingual communication. Educate and support patients and families by explaining medical information and resources in both languages. Maintain up-to-date knowledge of Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and other applicable regulations. Prepare accurate, timely reports and documentation while maintaining HIPAA compliance. Utilize medical and community resources for individuals with catastrophic or chronic conditions (e.g., spinal cord injuries, diabetes, cancer, orthopedic injuries).