Nurse Consultant Telephonic Case Management
Found in: Resume Library US A2 - 1 week ago
Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our clients and claimants, offering you the opportunity to join a team where your skills and dedication can truly make a difference. GUIDE. GUARD. GO BEYOND.
We believe that every candidate brings something special to the table, including you So, even if you feel that you’re close but not an exact match, we encourage you to apply.
Overview:
The ideal candidate will hold a compact nursing license, as well as CA, NY or IL licensure.
Responsibilities:
Provides medical management to workers compensation injured employees. Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers. Manage medical care in order to return injured employee to preinjury status. Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling. Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program. Evaluates home care services and equipment and determines need for home modifications. Coordinates home care. Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary. Analyzes results of treatment and medical status and reviews incoming provider reports. Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence. Generates reports to referral source to communicate case status, findings, and recommendations. Generates correspondence to referral source, medical providers, injured worker and other parties involved in the rehabilitation process. Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency. Documents case management observations, assessment, and plan in system. Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected.
Qualifications:
Required:
Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required.
Active Registered Nursing license or equivalent within the state of practice or states in which Case Management is performed.
Preferred:
Bachelor's degree preferred.
Worker's Compensation experience is preferred.
Certification in related field preferred.
Behaviors:
Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
Demonstrates good written and oral communications, organizational and leadership skills.
Computer literate.
Demonstrates good time management skills. Self starter.
#LI-HL1
#LI-Remote
Additional Information:
On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve:
Medical/dental/vision plans, which start from day one
Life and accident insurance
401(K) and Roth options
Tax-advantaged accounts (HSA, FSA)
Educational expense reimbursement
Paid parental leave
Other benefits include:
Digital mental health services (Talkspace)
Flexible work hours (availability varies by office and job function)
Training programs
Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
Charitable matching gift program
And more...
We value inclusion and diversity
Click to review our U.S. Eligibility Requirements
Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
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