Jobs · OTHR

Telephonic Case Manager

Sedgwick · Newport News, VA · 2 wk ago
OTHR$73k–$75k/yrFull-time

PRIMARY PURPOSE OF THE ROLE

While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services.

Essential Responsibilities

  • Performs initial and ongoing clinical assessment via telephone calls to evaluate the injured worker's injury, medical treatment, psychosocial needs, cultural implications and support systems.
  • Effectively communicates and builds relationships with the claims’ examiner, client, injured worker, attorney and supervisor.
  • Identifies issues related to delayed recovery and/or return to work and problem solves with a creative thinking approach.
  • Negotiates treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality.
  • Identifies opportunities to expedite care for cost containment and timely medical recovery.
  • Provides recommendations for alternate clinical resources to support claim resolution.
  • Maintains client's privacy and confidentiality, promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.

Education and Licensing

  • Current unrestricted RN license(s) in a state or territory of the United States required.
  • Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred.
  • Certification in case management, rehabilitation nursing or a related specialty is highly preferred.

Taking Care of You

  • Blended work environment.
  • Supporting meaningful work that promotes critical thinking and problem solving.
  • Providing on-going learning and professional growth opportunities.
  • Promoting a strong team environment and a culture of support.
  • Recognizing your successes and celebrating your achievements.
  • Thrives when everyone is working towards the same vision/goals.

Benefits

  • Three medical, and two dental & vision plans to choose from.
  • Tuition reimbursement.
  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
  • 4 weeks PTO your first full year.

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