Bilingual Medical Case Manager II

About the role

Work from home, and on the road. Monday – Friday, regular business hours.

Responsibilities

• Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
• Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
• Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Provides assessment, planning, implementation and evaluation of patient’s progress.
• Attends doctors, other providers, home and in some cases, attorney’s visits.
• Attends hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy.
• Initial home visit for initial evaluation.
• Implements care such as negotiation the delivery of durable medical equipment and nursing services.

Requirements

• Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
• Experience as a RN, Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Ability to meet with the patient, their physicians, other healthcare providers, attorneys, and advisors/clients and coworkers.
• A cost containment background, such as utilization review or managed care is helpful.
• Strong interpersonal, time management and organizational skills.
• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
• Ability to work both independently and within a team environment.
• Bilingual

Qualifications

• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation.
• Certification as a CCM, CIRS, or other Case Management certifications are preferred.

Skills

• Knowledgeable about workers' compensation, auto, health and disability management industries.
• Experience in managing medical case management.
• Ability to manage and coordinate care for injured workers.
• Strong interpersonal and organizational skills.
• Technical aptitude with MS Office.

Benefits

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

Pay

Pay Range: $65,436 – $98,982

Schedule

This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month. This role may require overnight travel.