RN-Medical Case Reviewer 2026-01345
Salary
$6,761.03 Monthly
Location
Cheyenne, WY
Job Type
Permanent Full-time
Job Number
2026-01345
Department
Department of Workforce Services
Division
Workers Comp - Casper
Opening Date
05/19/2026
Closing Date
5/29/2026 11:59 PM Mountain
FLSA
Determined by Position
Job Classification
SOMC10
Description and Functions
GENERAL DESCRIPTION:
The Wyoming Department of Workforce Services is seeking a Nurse Case Manager to coordinate, evaluate, and monitor medical care services provided to injured workers receiving benefits under the Workers' Compensation system. This position works closely with healthcare providers, employers, and division professionals to coordinate treatment plans and support injured workers in returning to their pre-injury level of functioning and employment.
Responsibilities include evaluating claimant needs and medical records to direct medical case management activities and ensuring that appropriate medical care is delivered in compliance with division statutes, rules, regulations, and treatment guidelines. The position performs medical review screenings on pre-authorization requests for surgical procedures, obtains and reviews supporting medical documentation, and refers cases for peer review when indicated.
Additional duties include documenting all interactions, reviews, approvals, and denials within the claims management system; reviewing CPT and ICD-10 codes and surgical descriptions for accuracy; and maintaining tracking systems for pre-authorizations, surgical procedures, clinical bills, and prescription requests. The Nurse Case Manager also reviews provider requests for compliance with treatment guidelines and serves as a medical resource for claims analysts by preparing medical questions for various evaluations.
This position further reviews medical bills, prescription requests, urinalysis drug screens (UDS), chiropractic and physical therapy treatments, and durable medical equipment (DME) requests to determine medical relatedness and appropriateness of care.
Laramie County is located in the southeast corner of Wyoming. Around the world, the very name Cheyenne conjures up images of cowboys, trains, and the great outdoors. Todays Cheyenne is all of that and more! Well always be here, ready to outfit you in new boots and hats, to point out the Wild-West history in our unique downtown, and to set you front and center at the worlds largest outdoor rodeo.
Working for the State of Wyoming offers more than a paycheck. Our total compensation package includes:
Want to see the full value of your compensation beyond salary? Explore our Total Compensation Calculator: https://compensationcalculator.wyo.gov
Human Resource Contact: 307-473-3270
ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function that may be performed at the job level.
Qualifications
KNOWLEDGE:
MINIMUM QUALIFICATIONS:
Education:
Bachelors Degree (typically in Nursing)
Experience:
1-2 years of progressive work experience (typically in Nursing)
Certificates, Licenses, Registrations:
Must be licensed or eligible for licensure as a Registered Nurse (RN) in the State of Wyoming
OR
Education & Experience Substitution:
4-6 years of progressive work experience (typically in Nursing)
Certificates, Licenses, Registrations:
Must be licensed or eligible for licensure as a Registered Nurse (RN) in the State of Wyoming
Necessary Special Requirements
PHYSICAL WORKING CONDITIONS:
NOTES:
Supplemental Information
053-Department of Workforce Services - Administration - Workers Safety & Compensation
Click here to view the State of Wyoming Classification and Pay Structure.
Click here to view the State of Wyoming Total Compensation Calculator.
URL: http://agency.governmentjobs.com/wyoming/default.cfm
The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.
Class Specifications are subject to change; please refer to the A & I HRD Website to ensure that you have the most recent version.
Working for the State of Wyoming means more than a job - it's a stable, rewarding career that lets you make a difference while enjoying a great quality of life.
Employees enjoy:
Know your full value.
Your paycheck is only part of the picture. The State of Wyoming offers a Total Compensation Calculator that shows the full value of your salary plus benefits, so you can clearly see what your complete compensation package looks like.
Explore your total compensation: https://compensationcalculator.wyo.gov/
WORKING FOR THE GREATEST STATE IN THE NATION - Wyoming offers a lifestyle you can't find anywhere else - wide-open spaces, clean air, friendly communities, year-round recreation, and no state income tax.
Click here for detailed information or you can watch this short video to learn about our benefit package!.
01
(AA) Which of the following best describes your highest completed level of education to date or within the next three (3 months)? (Transcripts may be required.)
02
(AA) Which of the following Quarter/Semester credit hours best describes your completed college education to date or within the next three (3 months)? (Transcripts may be required.)
03
(SOMC10) Which of the following best describes your work experience in RN- Medical Case Review? Experience definition: (Experience as an RN.)
04
(AA) Describe your relevant experience in the box below.
05
(SOMC10) Do you currently possess or are you eligible for licensure as a Registered Nurse (RN) in the State of Wyoming?
06
(SOMC10) Please provide your license no. in the box below.
07
Describe how you have applied the principles of nursing to your past work assignments. Specifically, demonstrate the role medical terminology, physical and psychosocial principles have been applied.
08
Describe the types of diagnostic testing you have interpreted, including the amount of time spent on this activity and how the data was applied to duties to be performed.
09
Describe community resources you are aware of that might offer assistance to injured or disabled individuals.
10
Summarize your skills and experience in counseling and consultation. Include Information on the type of conditions and patients included in your summary.
11
Describe how you have applied critical analysis to available information regarding a patients condition to arrive at a treatment plan for that condition. Include information demonstrating how you determined the correct protocol in these instances.
12
(DWS) Former State of Wyoming employees rehired within 31 days of their previous employment with the State will be required to repay any Sick and Annual leave payouts.
13
(DWS) The Wyoming Department of Workforce Services (DWS) uses E-Verify, an Internet-based system, to confirm the eligibility of all newly hired employees to work in the United States. Learn more about E-Verify, including your rights and responsibilities. I have read and understand the above statement.
14
(DWS) Please be advised that any offers of employment will be contingent upon the successful completion of a background check. I have read and understand the above statement.
15
(A1) Where did you hear about this opportunity?
16
(A1) If you selected "Current State Employee" please provide the employees first and last name, and include the department they work for, if known. This employee may be eligible for a Referral bonus.
17
(AA) If you anwsered Other, please tell us where.
18
(AA) VETERANS PREFERENCE DISCLOSURE: PER WYOMING STATUTE, current employees of the State of Wyoming are not eligible for veterans preference. If you are not a current employee of the State of Wyoming, to be eligible to receive veterans preference you MUST have been a resident of the State of Wyoming for a period of one (1) year or more at any time prior to submitting this application. I have read and understand the veterans preference disclosure.
19
(AA) VETERANS PREFERENCE: If you are a war veteran as defined in section 101, Title 38, United States Code or are the surviving spouse of a war veteran who receives survivor benefits from the federal government based on the veterans military service, and wish to claim veterans preference, please attach the appropriate documentation substantiating your claim. Indicate below your appropriate veterans preference status. By requesting veterans preference, you are certifying that you meet the statutory requirements as described in the above disclosure.
20
(AA) Please be advised that an incomplete application WILL NOT be considered for employment. An attached resume is not required and is not an acceptable substitution for a completed application. Some State of Wyoming agencies use E-Verify, an Internet-based system, to confirm the eligibility of all newly hired employees to work in the United States. Learn more about E-Verify, including your rights and responsibilities at https://www.uscis.gov/e-verify. I have read and understand the above statement.
Required Question
Employer State of Wyoming
Address Human Resource Contact Information located in the
General Description Section
Statewide, Wyoming, 82002
Phone 307-777-7188
Website http://agency.governmentjobs.com/wyoming/default.cfm