Field Nurse Case Manager - Louisville, KY

Gallagher•Louisville, KY

11d•Onsite

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 Louisville, Kentucky area, with a travel radius of up to two hours. The role includes coordinating medical evaluation and treatment, collaborating with physicians and injured workers on treatment plans and return-to-work goals, coordinating ancillary services, and communicating case status and recommendations to relevant parties. The case manager maintains at least 35 files and 150 monthly billable hours, with a minimum 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 in the state of practice or states in which case management is performed.
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 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, 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 to support effective outcomes.
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 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.
Travel to appointments within approximately a two-hour radius.