RN Medical Case Manager - Workers Compensation - Concentra Medical Clinic, Milwaukee, WI Job
Location: Brookfield Wisconsin
Description: Travelers is at present recruited RN Medical Case Manager - Workers Compensation - Concentra Medical Clinic, Milwaukee, WI Job right now, this career will be placed in Wisconsin. More details about this career opportunity kindly read the description below. Solid reputation, passionate people and endless opportunities.
That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
SUMMARY:
Travelers understands t! he importance of effective medical management of workers compe! nsation claims.
We are recognized as having the industry's most advanced approach to managing workers compensation claims. As a Travelers registered nurse, you will work onsite in the Concentra Medical Clinic at 5007 S. Howell Ave. in Milwaukee, WI. Our model provides a face to face level of care to actively manage the employee's claim needs, streamlines the process by enhancing the partnership between our nurse case manager and the Concentra Medical Clinic, ensures that the employees comply with the medical treatment plan developed by the physician to increase the likelihood of the employee's safe and prompt return to work, and expert, compassionate case management. You will meet with injured workers early in the process as well as for follow up treatment. You will help design quality, cost effective treatment plans by making case by case decisions based on a vast array of medical resources.
You will have the opportunity to make a difference in the lives ! of others each day, ensuring they get the best treatment for their injury, collaborating with physicians and helping them navigate the medical process.
PRIMARY DUTIES AND RESPONSIBILITIES:
- Contact medical provider and injured parties on claims involving medical treatment and /or disability to coordinate appropriate medical care. Develop medical management strategy and give the provider information necessary to facilitate a return to work plan on claims requiring disability management. Responsible for ongoing evaluation of treatment and return to work plan, within established protocols.
- Work with medical providers and suggest cost effective treatment alternatives, when appropriate. Help ensure that all injured parties are on an aggressive treatment plan. *Authorize medical treatment and associated diagnostic testing on assigned claims as allowed by state or policy jurisdictions. For nurses handling Workers Compensation Claims, perform Ut! ilization Review according to established guidelines. Utilize physician! advisor program.
- Proactively manage the medical expenses by partnering with specialty resources to achieve appropriate claim outcomes (SIU, Legal, Risk Control, Disability Management, IME and Peer Review vendors, Major Case, etc.)
- Obtain medical records from providers telephonically during initial contact, and follow up with written correspondence if necessary. Discuss medical information and disability status with claim handler and integrate into overall strategy to ensure appropriateness of indemnity payments. Provide technical assistance and act as a resource for claim handling staff.
- Contact employer to initiate modified duty or full return to work. Obtain job description and discuss job modifications required to ensure a prompt return to work. Medical Case Manager will work with employer, injured party, provider and claim handler to expedite return to work.
- Document all contacts and outcomes related to case activity in system. Submit billing reports on all activities per established guidelines.
- Provide feedback to Preferred Provider Network regarding provider nominations and experience with providers.
- Comply with established Best Practices
- Perform other duties as required.
Registered Nurse
CDMS, CRC, CCM, CRRN desirable
WORK EXPERIENCE:
Disability case management experience preferred.
CERTIFICATES/DEGREES:
Appropriate license per state regulation
COMMUNICATION SKILLS:
Very strong oral and written communication skills.
COMPUTER SKILLS:
Good computer skills
OTHER:
Strong clinical background.
Knowledge of medical causation and relatedness, as well as u! se of medical treatment protocols and physician advisor/peer review pro! grams.
Understanding of Workers Compensation laws or Auto First Party Medical preferred.
File Management
Nursing skills and knowledge
Customer Focus/ Communication
Relationship Management
Use of Technology
Travelers is an equal opportunity employer. We actively promote a drug-free workplace.
Job Category : Claim
Job ID: 811780
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Travelers.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Sun, 09 Feb 2014 17:36:56 GMT
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