SUPERVISOR, NURSE CONSULTANT II
3 weeks ago
This is a full-time remote position with a preferred location of Dallas, TX, however, qualified candidates in other locations within the Central time zone will be considered.
KNOWLEDGE AND SKILLS:
* Strong understanding of medical terminology, procedures, and best practices
* Strong leadership skills to manage, coach, and support a team of telephonic case managers
* Ability to analyze complex medical information and make sound decisions
* Strong organizational and time management skills to effectively prioritize tasks
* Ability to work independently and collaboratively in a multidisciplinary team environment to manage priorities and meet deadlines
* Excellent verbal and written communication skills to effectively deliver training and interact with adjusters, insureds, and vendors
* Proficient understanding of traumatic injuries, related disabilities, and potential medical complications
* Thorough comprehension of Workers' Compensation Acts and working knowledge of the medical providers in the assigned territory
* Proficiency and expertise in utilizing medical treatment guidelines and disability duration guidelines
* Willingness to travel as needed for on-site visits and meetings
MAJOR DUTIES/RESPONSIBILITIES OF THE JOB:
* Supervise a team of telephonic case managers, providing guidance, support, coaching and feedback
* Deliver training and education sessions to adjusters and insureds, ensuring a thorough understanding of medical programs and resources
* Interact with vendors, ensuring they comply with standards and deliver quality services to insureds
* Implement state managed care programs for insureds, including coordinating care, managing costs, and optimizing outcomes
* Provide oversight for catastrophic case management, ensuring appropriate and timely interventions for insureds with complex and high-acuity medical needs
* Throughout the life of an assignment review, analyze and critically assess medical records compared to evidence-based treatment guidelines; communicate findings and recommendations to the adjuster as part of the development of a medical action plan
* Active participation with claims team to review, establish, and execute action plan
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