Telephonic Medical/Disability Case Manager – RN

Attention Registered Nurses. Health Options & Management Services, Inc., is seeking case managers who want to apply their clinical talents as part of a team of workers’ compensation management professionals, in a clean, comfortable office setting. Daylight hours may vary slightly, Monday through Friday.

Our telephonic case managers liaison with insurance carriers, physicians and medical service providers, injured workers and their employers. They work with claims professionals to develop and plan strategies to manage medical/disability claims relative to workers’ compensation injuries, while identifying return-to-work opportunities.

• Establish telephone contact with injured workers to conduct intake interviews to obtain injury, treatment and other information.
• Coordinate medical care by developing, initiating and instituting rehabilitation plans for disabled individuals.
• Determine whether injured workers are being treated within requirements of applicable law(s).
• Team with other rehabilitation professionals to ensure appropriate and adequate physical care is being provided.
• Act as liaison to coordinate efforts with the injured worker, medical providers, attorneys, employers and insurance professionals.
• Maintain communication with treating and other healthcare providers, to receive status updates while ensuring compliance with medical treatment.
• Maintain communication with employers to discuss the medical condition of injured workers, determine employment availability and ascertain/define specific duties/ functions of pre-injury jobs.
• Maintain communication with injured workers and treating providers after each medical appointment to discuss progress and ongoing treatment plan(s).
• Maintain communication with employers to facilitate successful return and ensure continued success post-return.
• Complete various reports for insurance carriers during the care management process.
• Refer cases to field-based case managers when necessary.

Qualifications:

• A degree from an accredited nursing school.
• CCM, CDMS or other appropriate credential preferred.
• Current, Unrestricted Pennsylvania RN license.
• Three or more years of clinical nurse experience. Individuals with insurance, workers’ compensation case management, orthopedic, emergency room, critical care, etc., are preferred.
• Strong written and verbal communication skills while working in an electronic medium (e.g., basic computer skills), are preferred.
• Fluent Spanish or other language skills a plus.