Field Nurse Case Manager - Des Moines, IA

Gallagher•Des Moines, IA

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 the injured employee’s return to work. The position covers the Des Moines territory, with a travel radius of up to two hours. The role coordinates medical evaluations and treatment, collaborates with physicians and injured workers on treatment plans and return-to-work goals, and keeps employers and referral sources informed about medical treatment and work status. It also coordinates ancillary services, evaluates treatment outcomes using Evidence Based Guidelines, documents case observations and plans, and prepares reports and correspondence for the people involved in the injured worker’s treatment. The case manager may participate in telephonic case conferences and is expected to maintain at least 35 files, 150 monthly billable hours, and 95% quality compliance.

Requirements

Degree from an applicable program of training.
Minimum of 3 years of clinical experience in an acute care setting.
Active Registered Nursing license or equivalent within the state of practice or states in which case management is performed.
Adequate knowledge of managed care, including use of criteria, guidelines, and national standards of practice.
Advanced written and oral communication skills.
Organizational and leadership skills.
Ability to self-direct and proactively manage assigned case files.
Strong time-management skills.
Ability to travel to appointments within approximately a two-hour radius.

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 evaluations 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, including 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 to communicate case status and recommendations.
Generate ongoing correspondence to referral sources, employers, medical providers, injured workers, and other participants in the treatment plan.
Participate in telephonic case conferences as needed.
Maintain a minimum caseload of 35 files, 150 monthly billable hours, and at least 95% quality compliance.