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Nurse Case Manager - 1079501
SUMMARY: The Case Manager is responsible for the medical case management of injuries including catastrophic injuries. This role is responsible for the assessment, planning, coordination, implementation, and evaluation of injured/disabled individuals. A Case Manager/NWM works as an independently licensed professional as a part of a systematic care team to assist injured workers/consumers in their recovery so that they may return to the highest level of function as possible. DUTIES AND RESPONSIBILITIES: · Accepts cases for management in accordance with Medical Case Management Standards of Practice and established caseload per required productivity. · Conducts on site assessments for catastrophically injured individuals, gathers data and initiates case management process. · Establishes relationships and maintains communications with consumers, families, providers, the Management Team for risk-based contracts, attorneys (plaintiff and defense) and carrier clients and employers. Ensures that all communication is culturally sensitive and meets requirements to maintain injured worker confidentiality. · Educate and motivate consumers to reach their highest level of function. · Participates in all patient related conferences with the Management Team and assists with development of client contracts. · Completes accurate and timely written reports in accordance with organization’s documentation standards and Best Practices. · Represent organization in your role as a Network Manager by participating in pilot projects, training programs, and quality assurance efforts. · Responsible for complying with IT security requirement and policies. · Responsible for safeguarding related IT passwords. · Responsible for notifying of any IT security incidents per organization’s policies. · Other duties as assigned. QUALIFICATION REQUIREMENTS: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · Bachelor’s degree preferred or equivalent work experience. · Nursing license in state of practice required. Multi-state license preferred, if applicable. · Current unrestricted driver’s license required. · Must maintain certification with a national accrediting body such as CCMC or ARN, or be in the process of obtaining certification within 18 months of employment. In addition, Case Managers may also need regional or national certifications and must adhere to the standards of practice outlined by the specific certifying body or the jurisdictionally accepted standards of practice. · 2 years clinical experience or management of cases preferred within diagnostic categories (ABI, SCI, Multiple Trauma, Amputation, and Burn). · Excellent communication skills both written and verbal, excellent internal personal skills, and demonstrated ability to simplify complex material for training. · Intermediate computer skills including using the internet, Microsoft Outlook, Word, and Excel. Ability to work in multiple computer applications. · Ability to occasionally work outside of traditional business hours (evenings or weekends) if needed to meet the needs of the claim. · Self-motivated and able to work independently. · Strong reasoning Ability, ability to learn new processes quickly. Ability to analyze workflow and make recommendations for changing processes (e.g., simplifying) as appropriate. · Proven decision-making and critical thinking skills, requiring little supervision. · Problem solving and conflict resolution/negotiation skills. PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · Physical Activities: While performing the duties of this job, the employee is regularly required to reach with hands and arms, and to talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand and walk. · Weight Lifted/Force Exerted: The employee’s job does not require weight to be lifted greater than 20 pounds. · Vision Requirements: Specific vision abilities required by this job include close vision and the ability to adjust focus. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · Field/Home Office Environment: Home office plus travel between worksites and clients. The environment may vary between clients to include, but not limited to, residential homes, clinics, hospitals, manufacturing and normal office areas. Equipment: telephone, mobile devices, personal computer, calculator, fax machine, etc. · Position required driving of personal or leased automobiles for completion of task. Employee must maintain minimum insurance requirements for coverage. · Initial Motor Vehicle Report (MVR) must be completed and is it up to company whether or to we find an employee’s driving history to be acceptable. Employees whose MVR do not meet standards may have the terms of their employment change as a result of poor driving. · Employees must notify their supervisor of any accidents in the course of driving, as well as any adverse incident which will impact the MVR.