Occupational Health Nurse Case Manager

1 day ago

Kankakee, Illinois, United States Riverside Healthcare Full time
Job Title: Occupational Health Nurse Case Manager

We are seeking a highly skilled Occupational Health Nurse Case Manager to join our team at Riverside Healthcare. As a key member of our occupational health department, you will play a critical role in ensuring the health and well-being of our patients.

Job Summary:

The Occupational Health Nurse Case Manager will be responsible for coordinating care, case management, and facilitating timely return to work for occupational health injuries. You will serve as a liaison between all affected parties involved in the workers' compensation claim, including doctors, therapists, the injured worker, the employer, and the insurance company.

Responsibilities:
  • Obtain all workers' compensation patient claim information, including the insurance company processing the claim, claims adjustor handling the file, claim number, and claim status.
  • Act as a liaison between patients, providers, employer, and all affected parties to ensure prompt and effective injury treatment. Communicate with all affected parties the patient's ongoing injury treatment status.
  • Ensure all services, treatment, referrals, and procedures are authorized by the responsible party, scheduled accordingly and timely.
  • Follow the patient's status from initial injury treatment to ultimate deferral and/or discharge from the occupational health provider.
  • Maintain ongoing files of the open cases and their status for the provider on a weekly basis. Update documentation in the occ health software daily and ensure it is checked for errors.
  • Ensure updated records, progress reports, testing documentation, and lab results are disseminated to all affected parties in a timely manner.
  • Assist provider in preparation of appeals for insurance denials for injury treatment/procedures.
  • Complete any insurance forms, FMLA forms, disability forms at the request of the patient.
  • Coordinate care with respect to provider orders and referrals; initiate email and/or speak to provider daily in order to communicate patient progress.
  • Oversee and schedule in-house patient specialist appointments and ensure that recommendations and orders given by the specialists are carried out.
  • From time to time in the event of staffing shortage or volume surge, the Nurse Case Manager will be called to the floor in order to assist the Team with patient care. This may include and not limited to rooming patients, perform drug screens, N95 fit tests, and breath alcohol testing or any other service offered in the clinic.
  • Administrative tasks as directed.
  • Assist with protocol and process implementation.
  • Nurse Case Manager will cooperate with managerial decisions pertaining to the parameters of his/her job.
  • Obtain authorizations required for testing and treatment ordered by the providers.
  • Maintain professionalism when faced with the demands associated with the position.
  • Proactively manage all active claims to assess progress, prevent lapses or delays in treatment, obtain regular updates on work status, and facilitate injured worker's timely return to work.
  • Identify client needs with high injury rates and works with those clients to promote safe work practices.
  • Provide education to injured worker and our clients.
  • Maintain knowledge of workers' compensation laws and regulations.
  • Other duties as assigned.
  • Knowledge of current literature for worker's compensation and/or occupational health
  • Knowledge and understanding of OSHA guidelines and recommendations
  • Excellent verbal, written and communication skills
  • Excellent attention to detail and organization skills
  • Ability to coordinate care between multiple parties
  • Ability to educate staff and patients
  • Ability to make knowledgeable clinical assessments
  • Ability to work independently, collaboratively and possess initiative
  • Ability to work as a team and jump in to help the clinic with patient care
Requirements:
  • Successful completion of a practical nursing program or graduate of school of nursing
  • 3 or more years of case management for occupational health
  • Registered Nurse Licensed in the State of Illinois or Licensed Practical Nurse with successful completion and certification. CPR certification. DOT and Drug Screen Certifications.
About Riverside Healthcare:

Riverside Healthcare is a leading healthcare provider in the greater Kankakee area, known for our innovative approach to patient care and our commitment to excellence. We are proud to be ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery, and have been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times.

We are a place where opinions count and dedication is respected, where superior performance is rewarded with competitive salaries and excellent benefits. Join our team and be part of a culture that values innovation, teamwork, and patient-centered care.

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