Specialty Nurse Case Manager

CNA • Downers Grove, IL

6d • $54,000 - $103,000

About The Position

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Nurse Case Manager in a specialty area including but not limited to disability and psychiatry case management. Makes assessments and determinations applying various case and disability management principles within area of specialty. Ensures expeditious and effective claims decisions through collaboration with healthcare providers, employers, claimants and claims staff. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Assesses disability status, makes recommendations and identifies appropriate resources. Accountable for gathering and coordinating medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and assigns length of disability. Consults on case management issues in area of specialty and applies effective case management interventions. Collaborates with medical and other providers to ensure appropriate treatment and return to work. Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements while remaining externally focused. Addresses causality and refers to appropriate medical expertise. Documents according to jurisdictional, departmental and accreditation requirements. Reporting Relationship Typically Lead Specialty Nurse Case Manager

Requirements

• Strong knowledge of case management, specialty area, medical terminology and conditions, insurance industry as well as company policies and procedures.
• Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service.
• Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise and effective manner.
• Strong interpersonal skills with the ability to effectively interact with internal and external business partners.
• Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks.
• Knowledge of Microsoft Office Suite as well as other business related software.
• Ability to work independently.
• RN with BSN preferred.
• Eligible to sit for national case management certifications.
• Typically a minimum five years diverse clinical background, with two or more years disability management experience preferred

Responsibilities

• Assesses disability status, makes recommendations and identifies appropriate resources.
• Accountable for gathering and coordinating medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and assigns length of disability.
• Consults on case management issues in area of specialty and applies effective case management interventions.
• Collaborates with medical and other providers to ensure appropriate treatment and return to work.
• Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements while remaining externally focused.
• Addresses causality and refers to appropriate medical expertise.
• Documents according to jurisdictional, departmental and accreditation requirements.

Benefits

• CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.
• For a detailed look at CNA’s benefits, please visit cnabenefits.com
• CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [email protected]

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees