2 Essential Healthcare Solutions Jobs
Essential Healthcare Solutions is Hiring a Remote RN Case Manager (Field Nurse)
The RN Case Manager (Field Nurse) provides case management under the Nurse and Vocational Rehabilitation Case Management Services (NVRS) Contract, which supports the Office of Workmens Compensation Programs (OWCP) above and beyond the disability claims management process managed by a claims examiner by providing intensive and immediate intervention early in the disability period, assist with the medical management of disability claims, and assist with the provision of vacation rehabilitation services. The RN Case Manager (Field Nurse) assists in the medical management of disability claims and helps IWs to coordinate medical care and return to work. The RN Case Manager (Field Nurse) uses professional nursing knowledge, assessment skills, and technical skills to accomplish this. Support is primarily delivered remotely, but in person attendance at key medical appointments, home visits, and work site visits may be required when there are complications in care and to ensure continuity and forward progress to return to work.
Responsibilities include, but are not limited to:
- Assess the IWs current medical status, the anticipated duration of disability from work, and active treatment plan to ensure appropriate measures are in place to facilitate recovery and a timely return to work.
- Work with the medical providers to obtain appropriate treatment plans and coordinate recommended and approved medical care. (referrals to specialists or other health care providers, diagnostic testing, surgery, home care services, etc.).
- Review claimant eligibility for services, pending medical authorizations, and submit medical authorization requests, to assist providers and IWs in requesting authorization for medical services in a timely manner.
- Assess the IWs response to ongoing medical treatment, anticipated duration of disability from work, and medication management to provide recommendations or alternative treatment options to the physician and the Government to facilitate medical recovery and a timely return to work.
- Collaborate with the EA to identify light duty work accommodations and/or barriers to the return- to-work efforts and coordinating the return to work in a timely manner.
- Identify cases suitable for a referral for a Second Opinion medical examination and prepare cases for a referral for a Second Opinion medical examination. Prepare cases for a Second Opinion medical examination by completing file review, preparing the Statement of Accepted Facts (SOAF) and preparing appropriate questions for the examining physician.
- Identify any physical limitations or other barriers affecting the IWs adaptability to work duties, coordinating in the transition of the IWs return to work, monitoring success of return to work, and when needed via participation in on-site employer visits and follow up monitoring.
- Communicate promptly to the Government all case milestones/activities that require action (i.e. return to work, work stoppage, recurrence of symptoms, unrelated medical issues, etc.).
- Make recommendations for Vocational Rehabilitation and working cooperatively with rehabilitation counselors when appropriate.
- Maintain case records in the Governments system of record.
- Draft routine correspondence and interim communication, and all required work products/reports. (Initial Monthly Report, FN Monthly Case Management Reports, and Closure Reports, Second Opinion Prep Packets).
- Adhere to all timeframes for the delivery of case management services.
- RN with active, unrestricted license
- 2 years adult medical/surgical nursing experience AND 2 years case management experience in the worker compensation arena OR 1 years adult medical/surgical nursing experience AND 3 years case management experience in the worker compensation arena.
- Additional certifications preferred: COHN, CCM, CIRS/CRRN, CDMS, or ANCC/ANA.
- FECA nurse intervention program experience (within the last 5 years) preferred.
- Must possess strong computer skills in MS Office, including Excel, Word, Teams.
- Ability to type 45 wpm.
Remote work, from home office. Occasional travel, as deemed necessary and approved when there are complications in care and in-person support is critical to ensure continuity and forward progress to return to work.
This is a full-time position.
Job Summary
Full Time
Ancillary Healthcare
$91k-110k (estimate)
12/26/2023
05/16/2024
essentialhcsolutions.com
MEMPHIS, TN
25 - 50
2015
TIMOTHY AUSTIN
<$5M
Ancillary Healthcare
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About Essential Healthcare Solutions
Essential HealthCare Solutions, LLC is a national consulting firm and healthcare management company. The core services include building provider networks and healthcare consulting. The team has extensive experience in provider network development, contract negotiations, contract execution, healthcare consulting and management services. Our experienced team has payer and provider experience making us uniquely qualified to understand the marketplace, anticipate the needs and bridge any gaps. Our approach in building provider networks is: A comprehensive solution with the following three key area ...
s of focus: Provider Speed to Market We have developed statewide and national provider networks and can meet very aggressive milestones, engage providers and deliver quality contracts High Performing Networks Network status visibility and prioritization with competitive negotiations, well priced networks and ability to monitor goals Market Penetration Engagement of providers and facilities in the market area quickly to establish value proposition and relationships for network growth and sustainability as well as filling in gaps needed to meet network adequacy requirements Credentialing Verification We use a robust credentialing verification management system that performs primary source verification for state licensure, background checks, malpractice history and verification to ensure the safety of those that are served. We are confident in our abilities to bring contracted providers to any network and can build a robust network based in any timeline and within budget. Our expertise and vast experience in the healthcare field will contribute to the overall success of any project by accurately pricing the reimbursement to the providers for services rendered, effectively communicating the opportunity and secure their participation as well as secure payer contracts for providers that yield positive financial, on time deliverables and service outcomes.
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The job skills required for RN Case Manager (Field Nurse) include Case Management, Health Care, Home Care, etc. Having related job skills and expertise will give you an advantage when applying to be a RN Case Manager (Field Nurse). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by RN Case Manager (Field Nurse). Select any job title you are interested in and start to search job requirements.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
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