Nurse Case Manager

Chesapeake Employers' Insurance Company • Towson, MD

14d • $81,382 - $122,078 • Hybrid

About The Position

Supports the claims adjuster's management of files through application of medical expertise and case management principles by coordinating medically necessary and cost-effective medical treatment and services with a focus on an early and safe return to work.

Requirements

• Maryland RN License required.
• 3-5 years' experience in nursing.
• Familiarity with Windows, Word and Excel.

Nice To Haves

• Bachelor's Degree (BSN) preferred.
• Case management/utilization review experience preferred.
• Prior workers' compensation case management experience preferred.
• Workers Compensation Case Management (WCCM) and Maryland Certified Rehabilitation Service Practitioner (MCRSP) certification preferred.
• Certified Case Manager (CCM) preferred.
• Strong interpersonal skills.

Responsibilities

• Initiates injured worker, attorney, health care provider and employer contacts within protocols.
• Develops, implements and manages the medical and disability plans, and initiates appropriate and timely case management interventions.
• Implements and coordinates services with the injured worker, family and health care providers during case management phase and documents all case management activity.
• Obtains necessary information for purposes of facilitating the treatment plan and managing case progression.
• Authorizes medically necessary, evidence-based and cost-effective treatment.
• Coordinates services and resources necessary to expedite return to work.
• Acts as a resource by review of claims with all relevant parties, such as Claims, Health Services and Legal.
• Utilizes and monitors preferred vendors for select services to ensure prompt, cost effective service.
• Follows established precertification and utilization review policies and protocols.
• Acts as medical resource to peers, claims and legal personnel.
• Supports Health Services Departments to ensure optimal service delivery to all customers.
• Provides specialized case management services such as catastrophic case management or similar type roles.
• Pursues and participates in continual educational activities for self-development and in meeting all regulatory requirements.
• Responsible for delivery of customer service, exceeding expectations.

Benefits

• health, vision, and dental coverage
• a robust PTO plan
• an 8% employer contribution to retirement regardless of team member contribution
• educational assistance
• opportunities to participate in team member appreciation events
• STD, LTD and group life insurance 1X a team members salary
• free tickets to community attractions

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level