Field Nurse Case Manager - Baltimore, MD

Gallagher•Baltimore, MD

146d

About The Position

Provides medical management to workers' compensation injured employees through telephonic and in-person case management with injured workers and medical providers. Coordinates with employers and claims professionals to manage medical care and support injured employees' return to work. The role covers the Baltimore area, with a travel radius of up to two hours. The Field Nurse Case Manager 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 treatment and work status. The role also coordinates ancillary services, documents case observations and plans, evaluates treatment outcomes using Evidence Based Guidelines, and communicates case status and recommendations to relevant participants. The position maintains a minimum caseload of 35 files and 150 monthly billable hours, with a minimum 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.
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, 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 to ensure effective outcomes.
Document case management observations, assessments, and plans.
Generate reports for referral sources communicating case status and recommendations.
Generate ongoing correspondence to referral sources, employers, medical providers, injured workers, and other participants in the treatment plan.
May participate in telephonic case conferences.
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.