Healthcare Consultant

2 weeks ago

Philadelphia, Pennsylvania, United States Arthur J Gallagher & Co Full time

Healthcare Consultant - Wilkes-Barre
Join our expanding team of committed professionals at Arthur J Gallagher & Co, dedicated to guiding individuals towards optimal health and wellness outcomes.

As a member of our resilient team, you will collaborate to redefine excellence in healthcare services.

At our organization, we prioritize teamwork and strive to positively impact the lives of our clients and claimants, providing you with the opportunity to contribute your expertise and commitment to meaningful change.

Position Overview:
In this role, you will deliver medical management for workers' compensation injured employees, engaging in case management through both telephonic and in-person interactions with injured workers and healthcare providers.

Your responsibilities will include coordinating with employers and claims professionals to oversee medical care, facilitating the return of injured employees to work. This position will encompass a travel radius of up to 2 hours.

Key Responsibilities:

  • Coordinate medical evaluations and treatment plans.
  • Collaborate with physicians and injured workers to establish treatment goals and return-to-work strategies.
  • Keep employers and referral sources informed about medical treatment and work status.
  • Facilitate ancillary services such as home health, durable medical equipment, and physical therapy, while consulting with employers to identify job requirements and explore modified or alternative employment options.
  • Assess and discuss treatment outcomes with physicians and injured workers, utilizing Evidence-Based Guidelines to ensure effective results.
  • Document case management observations, assessments, and plans thoroughly.
  • Prepare reports for referral sources to communicate case status and recommendations.
  • Maintain ongoing correspondence with referral sources, employers, medical providers, injured workers, and other stakeholders involved in the treatment plan.
  • Participate in telephonic case conferences as needed.
  • Manage a caseload of at least 35 files, ensuring a minimum of 145 billable hours monthly, with a quality compliance rate of at least 95%.

Qualifications:

Required:

  • A nursing or medical degree from an accredited institution with an active Registered Nursing license or medical license in the relevant state.
  • 2-4 years of relevant work experience.
  • Commitment to completing necessary training to maintain proficiency and licensing requirements.
  • Ability to travel for appointments within a 2-hour radius.
  • Intermediate to advanced proficiency in computer skills, including Microsoft Office and Outlook.
  • WCCM certification.

Desired:

  • Bachelor's degree is preferred.
  • Experience in workers' compensation is preferred.
  • Certification in a related field is preferred.
  • 1-3 years of clinical experience is preferred.

Work Traits:

  • Demonstrates comprehensive knowledge of managed care, emphasizing the use of criteria, guidelines, and national standards of practice.
  • Exhibits advanced written and verbal communication skills, along with strong organizational and leadership abilities.
  • Self-motivated and capable of proactively managing assigned case files.
  • Displays effective time management skills.

Arthur J Gallagher & Co offers competitive salaries and a comprehensive benefits package, including medical, dental, and vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance programs, flexible work hours, training programs, and more.

Inclusion and Diversity:
We value inclusion and diversity as integral components of our business, woven into the fabric of our organization. For over 95 years, we have been committed to sustainability and supporting the communities where we operate.

We embrace the diverse identities, experiences, and talents of our employees, enabling us to better serve our clients and communities. We view inclusion as a conscious commitment and diversity as a vital strength.

Arthur J Gallagher & Co believes in equal employment opportunities for all individuals and prohibits discrimination based on any protected characteristics.

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