Experience:
3-5 years of experience
Concerned about your lack of experience? Learn More...
Employment Type:
Full time
Posted:
2/12/2018
Job Category:
Nursing
Industry:
Other
RN Case Manager
(This job is no longer available)
1-888-OHIOCOMP | Cleveland, OH
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Job Description

1-888-OHIOCOMP is currently seeking a Full-Time Nurse Case Manager for our Cleveland office. Candidates should have at least 2 years of clinical experience. Certified Case Manager (CCM) and familiarity with Ohio BWC desired but Occupational Medicine and or Orthopedic background helpful. We offer an excellent benefit package, daytime hours, 5 day work week, and a friendly office environment. Looking for team players with excellent communication and computer skills. Effective analytical and problem solving ability.

Responsible for providing case management services to injured employees covered under the Ohio Bureau of Workers' Compensation program. Acts as a liaison between the company, employer, injured worker (IW), provider of record, and any additional parties involved in the management of a claim. Monitors the IW's progress towards meeting goals and reports progress back to the employer. The goal of our case managers is make sure the IW is receiving the best medical care possible and to facilitate a safe and quick return to work.

Duties and Responsibilities:

  • Using the information gathered in assessment, formulates a case management plan that is specific to the individual using both independent and collaborative approach

  • Case management plan includes specific, measurable and achievable goals for the injured worker (IW) for a realist and timely return to work. The plan is to include interventions that will be identified as action plans that include the what, where, and how of the intervention.

  • Implements the case management plan by working with collaboratively with the employee, employer, and provider. May recommend treatment alternatives to the IW and provider based upon established guidelines and standard of care.

  • Maintains regular telephonic contact with IW to provide support and education regarding injury and care

  • Using clinical/nursing skills to help coordinate the individuals treatment while maximizing cost control

  • Periodically evaluates the case management plan for necessary revisions

  • Working with employers on job duty modifications based on medical limitations of the employee

  • Continuing phone contact with all parties involved to update and move along case activity

  • Maintains confidentiality and adheres to ethical, legal, and accreditation/regulatory standards when communicating with all members of the claim.

  • Authorizes treatment using the established criteria and performs manual bill review on assigned bills to ensure appropriate payment

  • Conducts timely and appropriate closure/termination of case management

  • Maintains knowledge of current URAC standards and BWC policy and procedure.

  • Participates in continuing education opportunities to further advance professional development

Serves as collaborator for IW, employer, and provider to achieve a unified.

Qualifications

Applicants must be eligible to work in the specified location