Field Nurse Case Manager - Richmond, VA

Gallagher•Henrico, VA

10d

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 Richmond, Virginia area, with travel within a radius of up to two hours. The role coordinates medical evaluations and treatment, works 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. It also coordinates ancillary services, documents case observations and plans, evaluates treatment outcomes using Evidence Based Guidelines, prepares case-status reports and correspondence, and may participate in telephonic case conferences. The position maintains a minimum caseload of 35 files, 150 monthly billable hours, and 95% quality compliance.

Requirements

Degree from an applicable program of training.
At least 3 years of clinical experience in an acute care setting.
Active Registered Nursing license or equivalent in the state of practice or states where case management is performed.
Able to travel to appointments within approximately a two-hour radius.
Adequate knowledge of managed care, with emphasis on criteria, guidelines, and national standards of practice.
Advanced written and oral communication skills, along with organizational and leadership skills.
Self-directed and able to 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 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, 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 participants in the treatment plan.
May participate in telephonic case conferences.
Maintain a minimum caseload of 35 files, 150 monthly billable hours, and minimum 95% quality compliance.