Field Nurse Case Manager - Raleigh, NC

Opus Medical•Raleigh, NC

3d•Remote

About The Position

The Field Nurse Case Manager serves as a nurse liaison coordinating care and communicating pertinent medical information among the Injured Worker, Insured, and Carrier. The role facilitates appropriate treatment, successful rehabilitation, and return to work, while delivering efficient, cost-effective communication for work injuries, motor vehicle accidents, liability claims, LTD/STD, and other referred services. This is a remote, field-based role involving regular local travel of up to two hours within the assigned region.

Requirements

Current, unrestricted Registered Nurse license.
Licensed in each state where field case management is provided.
Able to perform independent assessments within the scope of practice.
Practices in a U.S. state or territory that allows independent assessment within the scope of practice.
Completion of a nursing program and ongoing continuing education as required.
Must obtain and maintain at least one nationally recognized certification, such as CCM, CRC, CLNC, or CRRN, within three years of hire or within the state-required timeframe for practice, whichever is less.

Nice To Haves

Two years of full-time-equivalent direct case management experience for injured workers, or two years under supervision, preferred.

Responsibilities

Follow all policies and procedures in the Case Management plan and retain accountability for the case management process.
Accept referrals as assigned by the Director of Case Management.
Make initial contacts according to the Case Management plan, schedule the initial assessment, and obtain the date of the next physician appointment.
Confirm assignments with the referral source and clarify special handling instructions.
Build professional relationships with clients and treat claimants with dignity.
After physician appointments, contact the Carrier and Insured according to protocol and maintain ongoing communication with the Injured Worker, Insured, and Carrier.
Record data and billing in CaseAnyplace and submit timely monthly Preliminary, Initial, Progress, and Closing reports.
Attend physician appointments and obtain the diagnosis, prognosis, treatment plan, rehabilitation length, estimated return-to-work status (modified or regular duty), and MMI/Full Recovery information as appropriate.
Refer to a Vocational Counselor for job analyses when appropriate and approved by the Carrier.
Recommend IME physicians and coordinate and attend IMEs.
Coordinate transportation as needed.
Provide translation as needed for bilingual nurses.
Monitor the treatment plan, attend therapy sessions when appropriate, and maintain contact with therapists for updates.
Request transfer of files to a Vocational Counselor when appropriate, including LMS and Voc Rehab.
Assist the Carrier and Insured with return-to-work planning for modified or regular duty.
Provide information to Defense Attorneys as appropriate.
Promote teamwork with all staff members.
Maximize accurate, appropriate billable hours in line with the monthly target of 8 hours per day.
Maintain licensure and certifications and complete required annual training on time.
Perform additional professional duties as assigned.
Retain responsibility for tasks delegated to non-clinical staff.