RN Workers Compensation Case Mgr - (Work at Home)...Posted: August 17, 2010
This is a part time position ( 24 -32 hours per week/5 dats a week. The Workers Compensation Case Manager medically manages and/or assesses cases or tasks to facilitate return of ill/injured persons to productive lifestyles in an efficient, cost effective and timely manner. Analyzes and evaluates clinical and return-to work information so that an assessment with recommendations and goals can be established to optimize case outcome. Case management services are performed through field based (FCM) services. - Assesses the medical, vocational, financial, and behavioral needs of referred, ill/injured persons via combination of face-to-face, telephonic and written correspondence with a variety of parties, within the scope of the license/certification. Case management assessment and evaluation - gathering relevant medical and vocational information and data; interpreting same to develop a plan; requires interaction with the ill/injured person and specific goal-setting. Coordination of services based upon case-specific local, state and federal regulations as well as policy coverage pertinent to the case - Proposes and implements a cost effective vocational/medical case management plan to the referral source in the form of an initial report produced via personal computer. Modifies plan as needed based on case progress. Requires ability to negotiate with multiple parties. - Coordinates and implements the approved plan to successful completion and reports on the status via a progress/re-assessment report produced on the personal computer. Follow-up and evaluation of persons success relative to case plan; re-assessing case plan as necessary to ensure successful outcomes - Demonstrates appropriate outcomes measured during the life of a case against long and short-term goals; outcomes are summarized at the time of case closure the aim to maximize the persons outcomes and maximize medical status and return to work status. The aim is to return the person, as close as possible, to his/her pre-illness/pre-injury status. - Maintains accurate documentation of records on each case including assessment, goals, barriers, billing, savings and demographic data. Qualifications *Caseloads vary depending on client need and case complexity and method of delivery (field based vs. telephonic). Caseload size is adjusted based upon other duties. Average caseload size for a FT FCM is 25-30; for a FT TCM, 70-90. Education: Bachelors degree or higher in a health-related field (nursing) preferred along with appropriate licensure where required, i.e., R.N. license for nurses. Or Certification as a case manager Or RN license (Associates or Diploma degree nurse) with three (3) years full-time clinical experience. Certification: Certification is recommended and professionally encouraged. Approved certifications included Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Certified Occupational Health Nurse (COHN), Certified Rehabilitation Registered Nurse (CRRN) or Certified Rehabilitation Counselor (CRC). Certification as Certified Legal Nurse Consultant (CLNC), Certified Life Care Planner (CLCP) and Certified Nurse Life Care Planner (CNLCP) will also be considered as long as the individual meets the basic URAC education and experience requirements for case management staff. Knowledge and Experience: Staff must practice within the scope of their license (i.e., RN license, counselor license, etc.) and any code of ethics associated with any certifications; staff must maintain current licensure/certification Registered nurses must have minimum of three nursing experience in the one of following areas: ICU/CCU, trauma, spinal cord injuries, medical/surgical, orthopedics, neurology, or rehab. Pay Benefits Work Schedule CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development. How To Apply We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity. Please refer to job code 70037_HI_HONOLULU when responding to this ad.
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