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Nurse Consultant Telephonic Case Management
Location
United States
Posted
15 hours ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Nurse Consultant Telephonic Case Management
Gallagher
Role Description The Nurse Consultant - Telephonic will provide case management through telephonic contact with all medical providers, employers, claims professionals, and ancillary service providers. - Provides medical management to workers compensation injured employees. - Performs case management through telephonic contact with all medical providers, employers, claims professionals, and ancillary service providers. - Manage medical care in order to return injured employee to pre-injury status. - Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling. - Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program. - Evaluates home care services and equipment and determines need for home modifications. - Coordinates home care. - Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary. - Analyzes results of treatment and medical status and reviews incoming provider reports. - Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence. - Generates reports to referral source to communicate case status, findings, and recommendations. - Generates correspondence to referral source, medical providers, injured worker, and other parties involved in the rehabilitation process. - Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency. - Documents case management observations, assessment, and plan in system. - Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected. Qualifications - Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required. - Active Registered Nursing license or equivalent within the state of practice or states in which Case Management is performed. - Bachelor's degree preferred. - Worker's Compensation experience is preferred. - Certification in related field preferred. Requirements - Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines, and national standards of practice. - Demonstrates good written and oral communications, organizational and leadership skills. - Computer literate. - Demonstrates good time management skills. Self-starter. Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance. - 401(K) and Roth options. - Tax-advantaged accounts (HSA, FSA). - Educational expense reimbursement. - Paid parental leave. - Digital mental health services (Talkspace). - Flexible work hours (availability varies by office and job function). - Training programs. - Gallagher Thrive program – elevating your health through challenges, workshops, and digital fitness programs for your overall wellbeing. - Charitable matching gift program. - And more...
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