Nurse Case Manager - GA

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.

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.

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.
• 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.
  • CMM 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.

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.

Compensation and Benefits

• 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).