Workers Compensation Coordinator Case Management

TriHealth•Cincinnati, OH

15h•Hybrid

About The Position

This full-time opportunity, working in a results-driven, fast-paced setting, offers challenge, momentum and purpose! Partial work-from-home option available after successful completion of the orientation period and demonstration of time management and skills proficiency. Great benefits! Associate's Degree in Healthcare, Nursing or related medical field demonstrating knowledge and execution of injury/illness prevention, education, and rehabilitation (Required). Types of licensures ideal for the position with knowledge and execution of injury/illness prevention, education, and rehabilitation include but not limited to: RN, LPN, OT, OTA, PT, PTA, etc. Must demonstrate proficiency with standard office software, including word processing, spreadsheets, email, and web browsers. Must be able to learn new digital tools and systems quickly and apply them effectively in daily tasks. This position provides comprehensive case management for the team members of TriHealth in the specialty area of Workers' Compensation. This position assumes the roles included but not limited to coordinator, facilitator, educator, administrator, researcher, investigator, and consultant. The primary focus of this position is to control/minimize the cost of Workers' Compensation claims while promoting optimal recovery and minimal lost work time for TriHealth team members. This is accomplished through the coordination of referrals, treatment interventions, return to work, etc. with the parties involved in the Workers' Compensation claim. Skills/abilities to be successful in the position include excellent customer service, strong written/verbal communication, high computer literacy, organized with attention to detail, positive attitude, self-directed critical thinking, ability to work autonomously but also in a team atmosphere, can prioritize tasks and meet deadlines, high learning aptitude, and innate leadership that aligns with the mission and values of the organization. Additionally, the position requires working knowledge of medical terminology, body systems, and impairments and their disabling effects.

Requirements

Associate's Degree in Healthcare, Nursing or related medical field demonstrating knowledge and execution of injury/illness prevention, education, and rehabilitation. (Required)
1 - 2 years of experience in Clinical, Nursing or related medical field demonstrating knowledge and execution of injury/illness prevention, education, and rehabilitation. (Required)
Computer literate (see above).
Healthcare case management of occupational injuries, including return-to-work coordination knowledge needed.

Responsibilities

Collaborate with managers, team members, Workers' Compensation third-party partner to coordinate Modified Duty/Return to Work Program. Facilitate placements that meet team members' restrictions, monitor progress, and coordinate care to promote team members achieving optimum recovery from injuries/illnesses.
Regularly communicate with the Workers' Compensation third-party partner to monitor claims management including but not limited to the timely payment of bills/compensation, claim certification/denials, treatment requests, etc. Collaborate with appropriate provider contacts to facilitate timely exchange of documentation, referrals, workability status updates, etc.
Collect, document, and evaluate information regarding team member incidents/illnesses to determine individual needs. Plan and implement action to achieve optimum recovery and safe/timely return to work. Maintain communication with involved parties including but not limited to team members, managers, providers, Human Resources, etc.
Identify/track injury/illness trends/costs and provide meaningful information/reports to Occupational, Environmental, Safety, and Risk departments. Collaborate with various stakeholders to analyze and implement safety and injury illness prevention/education initiatives.
Adhere to all Workers' Compensation governing entities and employers' parameters, guidelines, policies, protocols, laws, etc. Follow OSHA recordkeeping guidelines and execute reporting of this information in a timely manner. Ensure compliance with Bureau of Workers' Compensation requirements for self-insured status.
Ensure compliance with HIPAA privacy requirements regarding the transfer of personal health information.
Cross train with Leave of Absence Disability Case Managers. Special projects as assigned.