Telephonic Case Manager

About 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. Work remotely in a non-traditional setting, applying medical/clinical or rehabilitation knowledge to manage complex conditions, treatment planning and recovery from illness or injury.

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 standards.
• 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 an accredited college or university or equivalent work experience preferred.
• Certification in case management, rehabilitation nursing or a related specialty is highly preferred.

Work environment requirements

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision and talking.

Pay

For the jurisdiction noted in this job posting only, the range of starting pay for this role is $72,000 – $75,000.

Benefits

• A comprehensive benefits package including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.