Telephonic Nurse Case Manager

Auto-Owners Insurance • Independence, MO

1d • Hybrid

About The Position

A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to: Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the claimant’s health across the care continuum. Coordinate care delivery and support among claimant support systems, including providers, community-based agencies, and family. Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability. Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services. Prepare and deliver trainings to claims staff via a variety of modalities including written materials, live presentations, WebEx and/or telephonic presentations. Identify opportunities, develop, and implement new clinical programs as well as improve existing programs and procedures. Assist in developing and maintaining vendor and consultant expectations and relationships. Negotiate rates with local healthcare providers including nursing homes, sub-acute facilities, and attendant care agencies. Assist with other duties in the clinical team department, or elsewhere, on request. .

Requirements

• Active RN license in good standing required, BSN highly preferred.
• Certification in Case Management (CCM) required or to be obtained within 18 months of hire.
• Minimum of three to five years clinical experience required.
• Strong clinical background in orthopedics, neurology, rehabilitation or trauma care is preferred.
• Minimum of three years experience as a case manager.
• Ability to communicate effectively in oral and written forms, read and interpret documents, and write routine reports and correspondence.
• Proficient computer skills including Microsoft Office products.
• Excellent problem resolution skills.
• This person should be able analyze details, make decisions, demonstrate innovativeness and continually seek more efficient ways to process and handle work for the benefit of the team.
• Excellent organizational skills with the ability to manage multiple priorities.
• Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.

Nice To Haves

• Insurance Rehabilitation Specialist (CIRS), Disability Management Specialist (CDMS), Rehabilitation Nurse (CRRN), or Occupational Health Nurse (COHN) a plus.
• Insurance experience a plus.
• Teaching or training experience a plus.

Responsibilities

• Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the claimant’s health across the care continuum.
• Coordinate care delivery and support among claimant support systems, including providers, community-based agencies, and family.
• Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability.
• Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services.
• Prepare and deliver trainings to claims staff via a variety of modalities including written materials, live presentations, WebEx and/or telephonic presentations.
• Identify opportunities, develop, and implement new clinical programs as well as improve existing programs and procedures.
• Assist in developing and maintaining vendor and consultant expectations and relationships.
• Negotiate rates with local healthcare providers including nursing homes, sub-acute facilities, and attendant care agencies.
• Assist with other duties in the clinical team department, or elsewhere, on request.

Benefits

• Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level