Remote, Work at Home Telephonic Case Manager

Mô tả công việc

We are currently seeking a Telephonic Nurse Case Manager (RN); Remote Work at Home. CCM required; UR experience preferred.Main responsibilities will include but are not limited to:• Using clinical/nursing skills to help coordinate the individual’s treatment program while maximizing quality of care and cost containment.• Performing three-point contacts:•Contact employee: expressing your and the employer’s concern for the employee’s health; educating the employee in company policies and regulations; supporting employee in complying with prescribed treatment plan; assessing employee motivation and resources (personal and interpersonal) that support return to work; and establishing and maintaining Case Management goals and expectations of return to work in a safe and timely manner with the employee.•Contact provider: identifying yourself and explaining your role; ascertaining treatment plan in order to assist patient compliance; requesting reports if appropriate; and determining return to clinic date, referrals and projected return-to-work date.•Contact employer/adjuster/insurer: providing diagnosis, therapy, providers and projected return-to-work date; providing hard copy follow-up within 72 hours of original contact date; and reviewing with employer the employee and provider’s concerns.• Objectively and critically assessing all information related to the current treatment plan to identify barriers, clarifying or determining realistic goals and objectives, and seeking potential alternatives.• Maintaining daily records of all contacts.• Generating and faxing, if requested, Initial or 72-hour report, including appropriateness of treatment plan and Case Management recommendations.• Serving as an intermediary to interpret and educate the individual on his/her disability, and the treatment plan established by the case manager, physicians, and therapists. Explains physician’s and therapists’ instructions, and answers any other questions the claimant may have in an effort to facilitate his/her return to work.• Working with the physicians and therapists to set up medical assessments to develop an overall treatment plan that ensures cost containment while meeting state and other• Researching alternative treatment programs such as pain clinics, home health care, and work hardening. Coordinating all aspects of the individual’s enrollment into the programs, and then monitors his/her progress, in an effort to maximize cost containment and minimize time away from work.• Working with employers on modifications to job duties based on medical limitations and the employees functional assessment. Helping employer rewrite a job description, when necessary and possible, in an effort to return the client to the workplace.• Monitoring/evaluating the employee’s progress.• Supplying employer/adjuster/insurer with periodic reports agreed to in original contract, but not less than biweekly.• Providing input on the performance of support staff to their supervisor.• Tracking client updates by use of daily open listing.• Attending scheduled staff meetings and in-service programs.• Other duties as assigned.• Maintaining the necessary credentials and demonstrating a level of professionalism within the work place and in dealing with injured workers reflects positively on the company as a whole.• Maintains professionalism at all times despite the stressful demands of the position. Capable of maintaining close relationships among all parties involved both in person and over the phone. Must be readily available for and responsive to all parties concerned.• Acquiring and maintaining knowledge of developments in the medical case management field. Keeping abreast of local workers’ compensation laws and regulations, as well as other issues in the case management field. This is also critically important in keeping licenses and certifications valid.• Seeking professional certification and participation in professional associations keeps the case manager informed of events in their field while establishing referral contacts.