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Medical Case Manager
2 months ago
We are seeking a skilled and compassionate Telephonic Medical Case Manager to join our team at AmTrust Financial Services, Inc. As a Telephonic Medical Case Manager, you will play a critical role in providing high-quality, patient-centered care to injured employees, while collaborating with healthcare providers and employers to achieve optimal medical outcomes.
Key Responsibilities- Utilize clinical expertise to assess patient needs and develop personalized care plans that promote timely and effective recovery.
- Conduct thorough reviews of medical records and communicate with healthcare providers to ensure that patients receive necessary treatments and interventions.
- Collaborate with employers to develop return-to-work plans that accommodate employee medical limitations and promote successful job placement.
- Provide education and support to patients and their families to empower them to take an active role in their care and recovery.
- Document all case management activities and communicate regularly with healthcare providers, employers, and other stakeholders to ensure seamless care coordination.
- Active unrestricted Nevada RN license.
- Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience.
- Certification in case management, pharmacy, rehabilitation nursing, or a related specialty is highly preferred.
- Ability to acquire and maintain appropriate Professional Certifications and Licenses to comply with respective state laws may be required.
- Written and verbal fluency in Spanish and English preferred.
- Five (5) years of related experience or equivalent combination of education and experience required to include two (2) years of direct clinical care or two (2) years of case management/utilization management.
- Knowledge of workers' compensation laws and regulations.
- Knowledge of case management practice.
- Knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
- Knowledge of URAC standards, ODG, Utilization review, state workers compensation guidelines.
- Knowledge of pharmaceuticals to treat pain, pain management process, drug rehabilitation.
- Knowledge of behavioral health.
AmTrust Financial Services, Inc. offers a competitive compensation package and excellent career advancement opportunities. Our benefits include:
- Medical & Dental Plans.
- Life Insurance, including eligible spouses & children.
- Health Care Flexible Spending.
- Dependent Care.
- 401k Savings Plans.
- Paid Time Off.
We strive to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion, or disabilities.
