Field Nurse Case Manager - Allentown, PA

Gallagher•Emmaus, PA

138d

About The Position

Provides medical management to workers compensation injured employees through case management involving telephonic and in-person contact with injured workers and medical providers. Coordinates with employers and claims professionals to manage medical care and support injured employees in returning to work. The position covers the Allentown area, with a travel radius of up to two hours. The role requires coordinating medical evaluations and treatment, collaborating with physicians and injured workers on treatment plans and return-to-work goals, and keeping employers and referral sources informed about treatment and work status. The case manager also coordinates ancillary services, evaluates treatment outcomes using Evidence Based Guidelines, documents case assessments and plans, prepares reports and correspondence, and may participate in telephonic case conferences. The position maintains a minimum caseload of 35 files and 150 monthly billable hours, with at least 95% quality compliance.

Requirements

Nursing or medical degree from an accredited institution.
Active Registered Nursing license or medical license in the state of practice or states where case management is performed.
2–4 years of work experience.
Complete required and applicable training to maintain proficiency and licensing requirements.
Ability to travel to appointments within approximately a two-hour radius.
Intermediate to advanced computer skills, including Microsoft Office and Outlook.
Knowledge of managed care, with emphasis on criteria, guidelines, and national standards of practice.
Advanced written and oral communication, organizational, and leadership skills.
Ability to self-direct and proactively manage assigned case files.
Strong time management skills.

Nice To Haves

Bachelor's degree preferred.
Workers' compensation experience preferred.
Certification in a related field preferred.
1–3 years of clinical experience preferred.

Responsibilities

Coordinate medical evaluation and treatment.
Meet with physicians and injured workers to collaborate on treatment plans and discuss return-to-work goals.
Keep employers and referral sources updated regarding medical treatment and work status.
Coordinate ancillary services, such as home health, durable medical equipment, and physical therapy.
Communicate with employers to determine job requirements and explore modified or alternate employment.
Discuss and evaluate treatment-plan results with physicians and injured workers using Evidence Based Guidelines.
Document case management observations, assessments, and plans.
Generate reports for referral sources communicating case status and recommendations.
Prepare ongoing correspondence for referral sources, employers, medical providers, injured workers, and other treatment-plan participants.
Participate in telephonic case conferences as needed.
Maintain a minimum caseload of 35 files, 150 monthly billable hours, and 95% quality compliance.