Telephonic Nurse Jobs

About The Position

Requirements

• Active Michigan RN license in good standing.
• Certification in Case Management (CCM), or ability to obtain it within 18 months of hire.
• Three to five years of clinical experience.
• At least three years of experience as a case manager.
• Ability to communicate effectively orally and in writing, read and interpret documents, and write routine reports and correspondence.
• Proficient computer skills, including Microsoft Office products.
• Excellent problem-resolution skills.
• Ability to analyze details, make decisions, demonstrate innovation, and seek efficient ways to process and handle work for the team.
• Excellent organizational skills and ability to manage multiple priorities.
• Ability to work in the U.S. without current or future sponsorship.

Nice To Haves

• Bachelor of Science in Nursing (BSN).
• Insurance Rehabilitation Specialist (CIRS), Disability Management Specialist (CDMS), Rehabilitation Nurse (CRRN), or Occupational Health Nurse (COHN) credential.
• Strong clinical background in orthopedics, neurology, rehabilitation, or trauma care.
• Insurance experience.
• Teaching or training experience.

Responsibilities

• Use case management processes to assess, develop, implement, monitor, and evaluate care plans across the care continuum.
• Coordinate care delivery and support among claimants’ support systems, including providers, community-based agencies, and family.
• Collaborate with claims associates and provide medical expertise in investigating, evaluating, and resolving workers’ compensation, personal injury protection, and liability injury claims.
• Evaluate medical records for injury relatedness and appropriate utilization of medical treatment and services.
• Prepare and deliver training to claims staff using written materials, live presentations, WebEx, and telephonic presentations.
• Identify opportunities and develop and implement new clinical programs and improvements to existing programs and procedures.
• Help develop and maintain 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, as requested.

Benefits

• Competitive base salary and compensation package.
• Matched 401(k).
• Fully funded pension plan once vested.
• Bonus programs.
• Paid time off, including holidays, vacation days, personal time, and sick leave.
• Structured training program.
• Employee mentoring.
• Friendly work environment.