Nurse (RN) Case Manager Specialist-LTD /STD-Phoenix, AZ

Mô tả công việc

CIGNA Disability Management Solutions' (DMS) goal is: "Return-to-work for every employee capable of working. We provide disabled workers with timely income replacement to protect their financial security if they are unable to work. All our decisions are fair, defensible and communicated clearly. We treat all our customers and their employees with the highest level of professionalism, respect and dignity."   We believe: Work is therapeutic and speeds the healing and recovery process Early return-to-work (RTW) supports CIGNA's objectives in work and business goals Keeping people at work improves a department's morale Healing occurs over time, and there should be progressive, incremental improvement in the employee's condition and ability to perform job duties A transitional work arrangement (TWA) heightens expectations of hardiness and performance over time, commensurate with the employee's functional capacity Any absence bears a cost to your budget - when an employee is out on disability you are paying for them anyway. ROLE SUMMARY:   The RN/Disability Clinical Case Manger does receive claim referrals and assesses medical/disability status and reports within quality assurance time frames. A typical day will include:-Monitors medical progress of claimants and reports on and plans for deviations from the normal recovery process/length of disability. -Evaluates timely activity and case development of an effective medical plan with the most appropriate outcome. -Routinely evaluates case studies to identify trends, issues, and concerns.  Makes any necessary modifications. -Participates directly in customer service calls, visits, pre-sales, installations, and renewals. -Supports CIGNA Group Insurance initiatives for quality improvement, change, growth, and excellence in business practices. -Understands and is able to articulate claimant's perspective -Facilitates relations with and between Claim Examiners, business partners, and customers to develop claim strategies, reduce the total cost of disability in all forms and implement improvement opportunities. -Collaborates with health care providers and ill/injured employees to promote accountability for the appropriateness and status of treatment plan and length of disability. -Acts as an advocate for injured/ill individuals through the assessment, planning, coordination, collaborating, evaluating, and communication of objective information regarding the medical status and state of well being. -Acts as a medical resource person for staff; provides educational opportunities for staff through training, inservice, and sharing of resources on one-on-one or group forums, whichever is most efficient and effective.