RN Field Nurse Case Manager
5 days ago
We are seeking a highly skilled and experienced RN Field Nurse Case Manager to join our team at EagleOne Case Management Solutions. As a key member of our team, you will be responsible for managing a caseload of active field case management files, providing expert consultation on medical information, and ensuring timely closure of files.
Key Responsibilities- Manage a caseload of 22-25 active field case management files, or 45-55 telephonic case management files, or 35-45 mixed TCM/FCM files, depending on complexity.
- Bill a minimum of 40 hours per week, with part-time employees handling a caseload of 12-18 files dependent on acuity.
- Maintain the Outlook calendar by keeping all meetings and appointments current and documenting changes as they occur.
- Attend and participate in all mandatory meetings, training, or corporate events, within person or through electronic means, as required.
- Make initial four-point contacts within 24-48 hours from the date of referral and send an initial email immediately thereafter.
- Closure of files with internal charting complete and up to date, including impact points.
- Apply Eagle One case management protocols and consult with Manager and internally roundtables on complex cases, claim barriers, and resolution planning.
- Create medical timelines and prepare case summaries for account claim reviews.
- Maintain a complete medical file in chronological order with no duplication of information in a paperless format.
- Alert Manager of any requests to deviate from Eagle One or account specific protocols and obtain approval to proceed as necessary.
- Utilize appropriate cost management programs per account or company protocol.
- Provide expert consultation for interpretation of medical information and how it impacts the case.
- Project anticipated dates for modified and full-duty work releases utilizing disability/medical criteria and documenting any deviations at each appointment.
- Address physical job demands and job availability at physician appointments to encourage appropriate work release.
- Contact medical providers within 24 hours of appointments to obtain disability and medical status.
- Determine and document appropriateness of medical treatment and whether or not the treatment meets disability/medical criteria throughout claim duration.
- Update employer and any other appropriate parties with any change in disability or medical status and appointment information within 24 hours of appointment date and coordinate return to work per protocol.
- Adhere to jurisdictional rules and regulations and apply to each case as appropriate.
- Attend all field visits as requested by client and account protocols and/or is available for field visits as needed, per Account Instructions and at client request, within an average 2 hour radius from home office.
- Meet or exceed Eagle One guidelines for return-to-work outcomes and medical closure durations.
- Active RN licensure in state of employment.
- Bachelor's Degree preferred.
- Additional certifications a plus (i.e. CCM, CDMS, CLNC).
- Knowledge of Microsoft Windows/Office (Word, Excel, and Outlook).
- Typing skills of 45+ wpm.
- Ability to work in a fast-paced environment.
- Strong organizational skills a must.
- Excellent written and verbal communication skills.
- Excellent customer service skills required.
- Previous case management experience a plus.
- Clinical experience in an orthopedic or occupational health setting a plus.
- Bilingual a plus.
- Valid driver's license and ability to drive to/from appointments if hired as a field case manager.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee must frequently lift and/or move up to 10 pounds.
While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee is frequently required to stand; walk; sit and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.
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