Telephonic Nurse Case Manager
W. R. Berkley Corporation
full-time
Posted on:
Location Type: Remote
Location: Illinois • United States
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Salary
💰 $75,000 - $88,000 per year
About the role
- Assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers
- Coordinate and implement medical case management to facilitate case closure
- Timely and comprehensive communication with employers, adjusters and the injured workers
- Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
- Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
- Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
- Acquire and maintain nursing licensure for all jurisdictions as business needs require
- Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
- Document activities and case progress using appropriate methods and tools following best practices for quality improvement
- Reviewing job analysis/job description with all providers to coordinate and implement disability case management
- Engage and participate in special projects as assigned by case management leadership team
- Occasionally attend on site meetings and professional programs
- Foster a teamwork environment
- Maintaining and updating evidence based medical guidelines in reference to the injured worker treatment plan and work status
- Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed
- Obtain case management professional certification (CCM) within 2 years of hire date
- Earn Continuing Education Units to maintain certifications and licensures
Requirements
- Minimum 2 years of experience in workers compensation insurance and medical case management preferred
- Minimum of 4 years medical/surgical clinical experience required
- Exhibit strong communication skills, professionalism, flexibility and adaptability
- Possess working knowledge of medical and vocational resources available to the Workers’ Compensation industry
- Demonstrate evidence of self-motivation and the ability to perform case management duties independently
- Demonstrate evidence of computer and technology skills
- Oral and written fluency in both Spanish and English a plus
- Graduate of an accredited school of nursing and possess a current RN license
- CCM preferred, Bachelor of Nursing preferred
- IL RN license required
Benefits
- Health
- Dental
- Vision
- Life
- Disability
- Wellness
- Paid Time Off
- 401(k)
- Profit-Sharing plans
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical case managementworkers compensation insuranceclinical experiencedata analysismedical record reviewcost effective caredisability case managementevidence based medical guidelinesvocational services coordinationnursing licensure
Soft Skills
communication skillsprofessionalismflexibilityadaptabilityself-motivationindependent workteamworkcase management leadershipproblem-solvingorganizational skills
Certifications
CCMRN licensestate certificationsContinuing Education Units