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.