Return to Work Coordinator

Gallagher•Franklin, TN

About The Position

The Return to Work Coordinator provides medical management and case management for employees injured at work, coordinating care through telephonic contact with medical providers, employers, claims professionals, and ancillary service providers. The role manages medical care to support the injured employee's return to pre-injury status. The coordinator reviews medical and rehabilitation services; arranges and coordinates evaluations, treatment, and counseling; evaluates home care services and equipment; determines the need for home modifications; and coordinates home care. The role works with employers to understand pre-injury job requirements and explore light-duty, modified, or alternate work. It also analyzes treatment results and medical status, identifies suitable employment consistent with the individual's limitations and capabilities, and communicates case status, findings, and recommendations through reports and correspondence. The position participates in telephone case conferences and training, documents case observations, assessments, and plans in the system, and maintains a caseload supporting at least 145 billable hours or an inventory of at least 72 files monthly, with 95% quality compliance expected.

Requirements

Degree from an applicable program of training.
At least 3 years of clinical experience in an acute care setting.
Active LPN nursing license or equivalent in the state of practice or states in which case management is performed.
Adequate knowledge of managed care, with emphasis on the use of criteria, guidelines, and national standards of practice.
Good written and oral communication, organizational, and leadership skills.
Computer literacy.
Good time management skills.
Self-starter.

Nice To Haves

Bachelor's degree.
Workers' compensation experience.
Certification in a related field.

Responsibilities

Provide medical management to workers' compensation injured employees.
Perform case management through telephonic contact with medical providers, employers, claims professionals, and ancillary service providers.
Manage medical care to help injured employees return to pre-injury status.
Review medical and rehabilitation provider services and coordinate appropriate evaluations, treatment, and counseling.
Communicate with physicians, injured workers, employers, referral sources, and other resources involved in rehabilitation.
Evaluate home care services and equipment, determine the need for home modifications, and coordinate home care.
Communicate with employers to determine pre-injury job requirements and explore light-duty, modified, or alternate employment.
Analyze treatment results and medical status and review incoming provider reports.
Identify suitable employment opportunities consistent with an individual's medical limitations and capabilities, aptitudes, and interests.
Generate reports and correspondence for referral sources, medical providers, injured workers, and other parties involved in rehabilitation.
Participate in telephone case conferences and internal and external training.
Document case management observations, assessments, and plans in the system.
Maintain a caseload supporting at least 145 billable hours or an inventory of at least 72 files monthly, with 95% quality compliance.