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RN Telephonic Case Manager II
4 months ago
We are seeking an RN Telephonic Case Manager II who will coordinate resources and create flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The RN Telephonic Case Manager II will utilize their medical knowledge to evaluate the patient's current treatment plan for medical appropriateness based on their physical and medical status. The successful candidate must be able to discuss the patient's medical and physical conditions with the treating physicians, along with discussing and recommending alternate treatment plans for the patient. They must also have the ability to explain medical conditions and treatment plans to the patient, family members, and adjuster, supporting the goals of the Case Management department and our company.
Responsibilities
- Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source.
- Assemble assessment, planning, implementation, and evaluation of patients’ progress.
- Evaluate patients' treatment plan for appropriateness, medical necessity, and cost effectiveness.
- Discuss the current treatment plan with the physician recommending alternate treatment plans and making independent medical decisions.
- Devise cost-effective strategies for medical care.
- Provide organized reports within a specified timeframe.
Requirements
- Bachelor's degree required, BSN desirable.
- Graduate of accredited school of nursing.
- Current RN compact licensure required.
- 3 or more years of recent clinical experience, preferably in rehabilitation.
- CCM required to be obtained within 3 years of hire, if no nationally recognized accreditation is present at the time of hire.
- Strong clinical background in orthopedics, neurology, or rehabilitation preferred.
About Us
We are a national provider of industry-leading risk management solutions for the workers' compensation, auto, health, and disability management industries. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity, and Teamwork. A comprehensive benefits package is available for full-time regular employees.
