RN Telephonic Case Manager

Acrisure•Bradenton, FL

2d•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 Other Duties: Please note this TCM job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.

Requirements

Current, active, and unrestricted RN license. Compact license preferred.
Additional licensure in CA, NY highly desired
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

Certification in the case management field preferred. Recognized certifications include CCM (Preferred) A-CCC, CCM, CDMS, CMAC, CMC, CRC, CRRN, and COHN
Experience in worker's comp case management, occupational nursing, or related field preferred
Fluent in English and Spanish highly desired

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.

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