RN Telephonic Case Manager

Acrisure • Bradenton, FL

10h • Remote

About The Position

Providing quality service and accurate results supports Ascential Care Partner’s primary mission as a trusted adviser to our clients. As a Telephonic Nurse Case Manager, you will be working in a fast-growing company and work environment. Your valuable role requires working closely with treating physicians/providers, employers, claim representatives, legal representatives, and the injured/ disabled person to create and implement safe and effective Return to Work plans, and facilitate appropriate and cost-effective medical services to achieve maximum medical improvement and recovery. As a member of our team, you will continue to reinforce Ascential’s mission of being a market leader and collaborative partner to current and prospective customers and partners. Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Case Management & Application of Knowledge: o Demonstrate and apply knowledge of case management standards, injuries, medications, treatment options, and job duties to advise on and implement treatment plans o Adhere to ethical guidelines and best practice standards, ensuring quality of care. ·Collaboration & Communication: o Collaborate telephonically and in writing with claims representatives, employer when applicable, and healthcare providers to achieve optimal return to work and claim outcomes o Facilitate telephonic and written communication and coordination with all appropriate parties o Maintain regular, frequent telephonic and written contact with patients throughout the claim assignment o Involve patients in decision-making and encourage their appropriate use of healthcare services to maximize health outcomes and maintain cost-effectiveness. Patient-Centered Care & Advocacy: o Assess patient needs, provide support and advocacy, promote self-advocacy and self-determination o Assist in safe transitioning of care, and resolve problems using multidisciplinary strategies, always prioritizing patient needs. Documentation & Confidentiality: o Maintain accurate documentation of case management services in client records o Uphold patient confidentiality and adhere to HIPAA standards. Quality Assurance: o Ensure quality of care by adhering to standards, measuring outcomes, making necessary adjustments, and following ethical guidelines. o Reflect the company’s philosophy by demonstrating ardent customer service-related results. Professional Development: o Maintain professional and industry knowledge through continuous learning, networking, and participation in professional activities. o Maintain state license(s) and certifications required for this role. Workload Management: o Manage assigned workload independently, prioritizing cases, evaluating progress, and modifying goals to improve treatment effectiveness and claim outcomes. o Perform other duties as assigned

Requirements

• Current, active, and unrestricted RN Compact license.
• Two or more years’ full-time work providing direct clinical care
• Associate degree or bachelor’s degree in nursing
• Able to think critically and strategically to accomplish case goals
• Excellent interpersonal skills, and customer service focused
• Assertive and proactive in approach and communications
• Maintains confidence and tact in difficult discussions and collaborations to achieve positive outcomes
• Possesses strong organizational, task prioritization, and delegation skills
• Demonstrates technical proficiency in Microsoft Office products and ability to learn new software
• Ability to maintain accurate records, prepare reports, correct English usage, and maintain confidentiality
• Ability to construct grammatically correct reports using standard medical terminology
• Ability to use a computer keyboard and mouse up to 8 or more hours per day
• Full-time, work from home position that can be located anywhere in the U.S.
• Ability to work normal business hours for assigned jurisdiction(s)
• Must have dedicated home office space that ensures privacy with access to reliable high-speed internet

Nice To Haves

• Additional RN licensure from CA, TN, NC or NY strongly preferred.
• Certification in the Case management field strongly preferred. Recognized certifications include CCM (Preferred) A-CCC, CCM, CDMS, CMAC, CMC, CRC, CRRN, and COHN
• State Specific certifications strongly desired GA Rehab Supplier, NC QRP
• Experience in worker's comp case management, occupational nursing, or related field preferred
• Bilingual (Spanish speaking) is strongly preferred

Responsibilities

• Demonstrate and apply knowledge of case management standards, injuries, medications, treatment options, and job duties to advise on and implement treatment plans
• Adhere to ethical guidelines and best practice standards, ensuring quality of care.
• Collaborate telephonically and in writing with claims representatives, employer when applicable, and healthcare providers to achieve optimal return to work and claim outcomes
• Facilitate telephonic and written communication and coordination with all appropriate parties
• Maintain regular, frequent telephonic and written contact with patients throughout the claim assignment
• Involve patients in decision-making and encourage their appropriate use of healthcare services to maximize health outcomes and maintain cost-effectiveness.
• Assess patient needs, provide support and advocacy, promote self-advocacy and self-determination
• Assist in safe transitioning of care, and resolve problems using multidisciplinary strategies, always prioritizing patient needs.
• Maintain accurate documentation of case management services in client records
• Uphold patient confidentiality and adhere to HIPAA standards.
• Ensure quality of care by adhering to standards, measuring outcomes, making necessary adjustments, and following ethical guidelines.
• Reflect the company’s philosophy by demonstrating ardent customer service-related results.
• Maintain professional and industry knowledge through continuous learning, networking, and participation in professional activities.
• Maintain state license(s) and certifications required for this role.
• Manage assigned workload independently, prioritizing cases, evaluating progress, and modifying goals to improve treatment effectiveness and claim outcomes.
• Perform other duties as assigned

Benefits

• Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
• Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
• Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
• Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree