Nurse Case Manager
About The Position
The Nurse Case Manager will be expected to effectively collaborate with the interdisciplinary team on a regular basis in both a verbal and written capacity. They must be adept in their abilities to assess, plan, implement, coordinate, monitor, and evaluate clinical options and services to promote optimal patient/injured worker outcomes. They should have a strong capability to comprehend and facilitate cost-effective care to ensure medical services are provided in an optimal clinical setting as well as in a timely manner. The Case Manager will assist claims specialists and the medical management team in ensuring compliance with evidence-based guidelines, organization clinical protocols, and Medicare Secondary Payer Act.
Requirements
- Minimum of 5 years of nursing and nurse case management experience
- Minimum of 1 year of experience in the workers’ compensation industry preferred
- Track record and comfort in collaborating with interdisciplinary teams and providers
- Ability to lead and coordinate activities with a diverse group of individuals
- Conversant knowledge and experience with case management care coordination and/or utilization review
- Demonstrated ability to critically think and effectively problem solve
- Exceptional communication skills
- Basic knowledge and experience in Microsoft Office programs
- Excellent time-management skills
- Graduate of an accredited school of nursing, degree in nursing science, or other qualification recognized by the state(s) which possesses nurse licensure
- Active registered nurse license
Nice To Haves
- Bilingual in English/Spanish strongly preferred
- Advanced clinical knowledge
- Musculoskeletal and/or trauma experience a plus
- Bachelor’s Degree preferred
Responsibilities
- Assess, plan, implement, coordinate, monitor, and evaluate clinical options and services to promote optimal patient/injured worker outcomes.
- Facilitate cost-effective care to ensure medical services are provided in an optimal clinical setting and in a timely manner.
- Assist claims specialists and the medical management team in ensuring compliance with evidence-based guidelines, organization clinical protocols, and Medicare Secondary Payer Act.
- Collaborate with the interdisciplinary team on a regular basis in both a verbal and written capacity.
Benefits
- Specialized coverage and risk management solutions
- Claims handling
- Loss control
- Underwriting
- Longshore consulting
- Leadership training
- Comfortable working environment in a modern-classic office space with beautiful views
- Named one of the Best Companies to Work for in Alabama for six years straight
- Collaborative, positive, and engaging company culture
- Strong tradition of corporate charitable promotion
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
