Field Nurse Case Manager - Atlanta, GA

Gallagher•Atlanta, GA

53d

About The Position

Provides medical management to workers compensation injured employees through 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 Atlanta area, with travel of up to a two-hour radius. The case manager coordinates medical evaluation and treatment, collaborates with physicians and injured workers on treatment plans and return-to-work goals, and keeps employers and referral sources informed about treatment and work status. The role also coordinates ancillary services, evaluates treatment results using Evidence Based Guidelines, documents case observations and plans, and provides status reports and correspondence to involved parties. 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 within the state of practice or states in which case management is performed.
2–4 years of work experience.
Ability to travel to appointments within approximately a two-hour radius.
Intermediate to advanced computer skills, including Microsoft Office and Outlook.
Adequate knowledge of managed care, emphasizing use of criteria, guidelines, and national standards of practice.
Advanced written and oral communication skills, organizational skills, 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 to ensure effective outcomes.
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 treatment-plan participants.
Participate in telephonic case conferences as needed.
Maintain a minimum caseload of 35 files and 150 monthly billable hours, with minimum 95% quality compliance.
Complete required and applicable training to maintain proficiency and licensing requirements.