POSITION SUMMARY: Supports the claims adjuster's management of files through application of medical expertise and case management principles by coordinating medically necessary and cost-effective medical treatment and services with a focus on an early and safe return to work.________________________________________DUTIES AND RESPONSIBILITIES:  Initiates injured worker, attorney, health care provider and employer contacts within protocols. Develops, implements and continually manages and reassess the medical and disability plans, and initiates appropriate and timely case management interventions. Implements and coordinates services with the injured worker, family, and health care providers during case management phase and documents all case management activity. Obtains necessary information for purposes of facilitating the treatment plan and managing case progression. Authorizes medically necessary, evidence-based and cost-effective treatment to include pharmaceutical and Durable Medical Equipment needs. Coordinates services and resources necessary to expedite return to work. Acts as a resource by review of claims with all relevant parties, such as Claims, Health Services and Legal. Utilizes and monitors preferred vendors for select services to ensure prompt, cost effective service. Follows established precertification and utilization review policies and protocols. Reviews medical bills and expenses as needed. Acts as medical resource to peers, claims and legal personnel. Supports Medical Services Teams as well company-wide initiatives to ensure optimal service delivery to all customers. Provides specialized case management services such as catastrophic case management or similar type roles. Pursues and participates in continual educational activities for self-development and in meeting all regulatory requirements. Responsible for delivery of customer service, exceeding expectations. As an employee of Chesapeake Employers’, must safeguard the privacy and security of our clients' information. This means following Chesapeake Employers privacy and information security policies and procedures. If you notice any unusual or suspicious activity, you must report it immediately. As part of your normal job duties, you may come across sensitive or confidential information and are responsible for keeping our data secure and confidential. Supports the company strategies and department goals by accomplishing tasks as assigned.________________________________________SKILLS, EDUCATION AND EXPERIENCE:  Maryland RN License required.  Bachelor’s Degree (BSN) preferred.  Workers Compensation Case Management (WCCM) and Maryland Certified Rehabilitation Service Practitioner (MCRSP) certification required within 3 months of employment. Case management/utilization review experience preferred. Certified Case Manager (CCM) preferred. Prior workers’ compensation case management experience preferred. 3-5 years’ experience in nursing. Strong interpersonal skills. Multi-tasking and strong attention to detail required. Basic PC skills (Windows, Word). Bilingual skills preferred.________________________________________POSITIONAL COMPETENCIES:  Bias for Action Knowledge Sharing Deliver Results  Service and Sales Excellence Personal Leadership Teamwork and Communication________________________________________PHYSICAL DEMANDS:While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle or feel objects, tools or controls; reach with hands and arms. The employee is occasionally required to stand, walk, stoop, kneel, crouch or crawl. The employee may occasionally lift up to 30 pounds. Specific vision abilities are required, which includes close vision, peripheral vision and the ability to adjust focus.________________________________________WORK ENVIRONMENT:Office Environment. The noise level is usually moderate.