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Nurse Case Manager
Philadelphia, PA
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| Career Field |
Medical/Case Management
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| Insurance Discipline |
Managed Care
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| Relocation Assistance |
Not Available
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| Job Duration |
Full Time |
| Salary Offered |
$65,000 - $65,000/ year
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Position Overview: Responsible for case work, case management and establishing effective business contacts to promote case referrals. Provide comprehensive medical case management, medical planning; development; record review for referral sources. Establish Return to Work plan for client to original employer.
Essential Job Functions:
Immediate response to new referral to include three point contact with employer, injured worker and physician
Coordinate Initial Assessment with claimant
Obtain a signed authorization for release of medical records
Work with physician of record to coordinate/facilitate goal oriented medical treatment
Work with Employer to develop modified duty to facilitate return to work
Document and report findings at least every 30 days in a written report to referral source
Provide verbal and e-mail updates to referral source weekly or as events dictate
Provide support to claimant and family during case management phase
Develop rehabilitation plan via customer and state guidelines
Assess patient needs from medical record review
Other Responsibilities:
Coordinate/act as liaison among all members of the health care team to ensure follow- through of goals and objectives of the medical treatment plan
Collaborate with multidisciplinary team members to produce effective/positive patient outcomes
Pro-actively assess appropriate level of care based on patient's clinical picture
Provide career guidance counseling to client
Obtain signed job descriptions from claimant's physician of record
Coordinate Independent Medical Evaluations with appropriate physicians
Spearhead open communication between the employer's representative and claimant
Provide all required documentation needed to facilitate the Return-to-Work
Obtain a job description for full/modified duty from employer
Provide aggressive and thorough 30-day follow-up post Return to Work
Primary People Contact:
Referral Source
Physicians
Therapists
Attorneys
Claimants
Prerequisites:
Active license as a Registered Nurse
Previous case management experience and worker's compensation experience preferred
Prior clinical experience in ER,OR,ICU, trauma
BSN and/or CCM a plus
Behavioral Traits, Attitudes and Skills Required to be a Successful Case Manager:
Self directed and self motivated
Demonstrate highly professional approach and possess innovative knowledge in the medical case management field
Excellent problem solving skills
Converse with physicians, therapists, occupational nurses, attorneys, adjusters and employers in a positive manner,
Strong understanding of worker's compensation and the laws surrounding worker's compensation
Flexible and innovative, common sense, and good listening capabilities
Time Management
Strong written and verbal communication skills
Computer Skills
Microsoft Office 2003 experience
Physical and Sensory Requirements:
Ability to travel (within a 75 mile radius, with possibility of more than 75 miles infrequently)
Car for Travel
Valid Drivers License
Performance Measurement Criteria:
Effective and accurate management of cases
Work as a team player
Accurate reports in a timely manner
Ability to manage a case load of 25
Allocation of Time:
88% Case Management
12% Documenting Reports
In-House Training:
Work with Director/Supervisor
Work with other case managers
Attend guest lectures/present as scheduled
Attend in-house seminars and presentations
Attend staff meetings
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Please Reference NIRA# 6143/GIR43607
QuestPro Consultants
Jason Simmons
17300 Preston Road, Suite 350
Dallas, TX 75252
(972)960-1305
(972)960-1357 -- fax
jsimmons@questpro.com
http://www.questpro.com
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