Telephonic Nurse Case Manager
New
R
Rising Medical Solutions, Inc.Healthcare case management
United States, 9:00am CST to 5:30pm CST, with the ability to flex time based on the jurisdictionFull-TimeManager
Salary not disclosed
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Job Details
- Experience
- At least 3 years of TCM experience preferred
- Required Skills
- Microsoft Excel
Requirements
- Hold an RN license; a compact-state RN license is preferred, and a California RN license is a plus.
- Have an associate degree.
- Have at least 3 years of TCM experience preferred.
- Have experience with Workers’ Compensation or Disability Management.
- Demonstrate strong computer skills, including Microsoft Outlook, Excel, and Word.
- Be available to work full time from 9:00am CST to 5:30pm CST, with flexibility based on jurisdiction.
- Maintain confidentiality of information, policies, and procedures.
- Demonstrate knowledge of utilization management, case management, and healthcare across the health continuum.
- Have strong oral and written communication skills with a customer-service focus.
- Be able to gather data, compile information, and prepare summary reports.
- Demonstrate time management, organization, prioritization, interpersonal, and conflict-resolution skills.
- Be able to work autonomously and as part of a team in a fast-paced environment.
- BSN, CCM, or other insurance or workers’ compensation certifications are a plus.
Responsibilities
- Establish collaborative relationships and act as an intermediary between clients, patients, employers, providers, and attorneys.
- Assess, coordinate, implement, monitor, and evaluate care plans using medical necessity, care appropriateness, and managed care principles.
- Promote quality, cost-effective care throughout the health continuum.
- Document case savings and ongoing case management activity.
- Maintain organized files containing clinical documentation of interactions with all parties to each claim.
- Assess injury severity, extent of disability, treatment plans, functional abilities, and physical job requirements.
- Establish return-to-work plans and strategies to manage future medical exposure.
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