Specialized Services Clinical Administrator

Professional Case Management•Milwaukee, WI

2d•Onsite

About The Position

Put your talents to work at PCM! Whether you work in our Home Care, Clinical Research, Impairments, or Catastrophic Care division, you will support our mission to deliver care and other services that enhance the quality of life of our clients. Be a part of our dynamic client-focused team and make a difference in your career! Performs advisory activities to assist a Specialized Services Physician with all the tasks necessary to write medical opinion letters for PCM Home Care clients.

Requirements

Registered Nurse
Knowledge of the EEOICPA program and key stakeholders’ operating practices (e.g. DOL Resource Centers) is strongly preferred
Demonstrates strong verbal, written and interpersonal communication skills.
Strong computer skills.
Speaks, reads, writes, and comprehends English. Written communication is particularly important in this role.
Demonstrates time management, organizational skills, and ability to function with minimal direction.
Extensive knowledge of conditions that are common to White Card holders/EEOICPA claimants.
Utilize strong phone skills – this role requires extensive time on the phone, but is not considered a Call Center position
Provide exceptional customer service to claimants
Build strong relationships with team members, physicians, and Case Managers.

Nice To Haves

Experience with letter writing on behalf of claimants in the EEOICPA Program is highly desirable.
Offers subject matter expertise and creativity in helping claimants whose circumstances lie outside of established processes

Responsibilities

Liaising with PCM’s Clinical Operations and Home Care clients regarding prospective new conditions that can potentially be added to a client’s white card
Write clinical summaries to assist the Specialized Services physician
Educate Home Care clients on the benefits to them of adding new covered conditions
Document all steps in Salesforce and update as applicable
Work directly with clients and Case Managers to guide them through the DOL process
Request records from treating physicians and providers in support of the claim
Follow up with claimants at each step of their DOL authorization process to gauge progress and offer additional guidance
Answer claimant questions regarding the DOL - processes and EEOICPA program and benefits