Industrial Rehabilitation Nurse (PN 20069122)

State of Ohio • Columbus, OH

7d • Onsite

About The Position

Responsible for managing a group of serious injury cases for the BWC Catastrophic (CAT) Nurse program. The goal is to make sure injured workers get timely services and to help solve medical or claim issues. This includes working closely with the injured worker, the BWC Claims team, MCO CAT Case Managers, the employer, and medical providers to support recovery and return to work whenever possible. Reviews referrals to decide whether a claim should receive a catastrophic designation. It also involves checking that the claim has proper allowances and adding or removing the CAT flag and case dates based on BWC policy. Authorizes and oversees home and vehicle modification services in both catastrophic and non-catastrophic claims. These services are provided by outside vendors and must meet BWC policies and criteria. Keep accurate data records and meeting all timeliness and quality standards. Take part in quality reviews when needed. Serves as a subject matter expert on BWC catastrophic injury management, policies, and procedures. Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

Requirements

• Current & valid license to practice professional nursing as Registered Nurse (i.e., R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Ohio Revised Code AND 6 mos. exp. as licensed Registered Nurse.
• Knowledge of\: case management strategies, nursing and medical treatment protocols, healthcare coverage and reimbursement policy, BWC policies & procedures, ICD coding; public relations; medical terminology
• Ability to: interpret diagnoses, assess limitations & write accurate medical reports based on claim data; read & comprehend medical charts, manuals & journals; medical policy & guidelines; handle routine inquiries from & contacts injured workers, employers, physicians, attorney’s, government officials, providers or representative & general public; display excellent written and verbal communication skills; operate a computer and be proficient in Microsoft Office programs, including but not limited to MS Word and Excel; must be able to operate office equipment (e.g., copier, printer, calculator); independently review medical bills to analyze costs & deem appropriateness () Developed after employment.
• This position requires a current & valid license to practice professional nursing as registered nurse (i.e. R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Ohio Revised Code. To remain in this classification after employment, incumbent is required to renew license to practice as a registered nurse on a biennial basis.
• Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.

Responsibilities

• Managing a group of serious injury cases for the BWC Catastrophic (CAT) Nurse program.
• Working closely with the injured worker, the BWC Claims team, MCO CAT Case Managers, the employer, and medical providers to support recovery and return to work whenever possible.
• Reviews referrals to decide whether a claim should receive a catastrophic designation.
• Checking that the claim has proper allowances and adding or removing the CAT flag and case dates based on BWC policy.
• Authorizes and oversees home and vehicle modification services in both catastrophic and non-catastrophic claims.
• Keep accurate data records and meeting all timeliness and quality standards.
• Take part in quality reviews when needed.
• Serves as a subject matter expert on BWC catastrophic injury management, policies, and procedures.

Benefits

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
• Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation )

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 101-250 employees