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| Designation: |
Workers Compensation Nurse Case Manager in Philadelphia, PA |
| Department: |
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Insurance, Nursing |
| Job type: |
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Full time |
| Location: |
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Philadelphia, Pennsylvania |
| Salary: |
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Not specified
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| Description: |
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FILLED
Our client provides multi-support services to the insurance industry with its panels of experts and providers that facilitate proper medical care for treatment of work related injuries and evaluation of claims issues to achieve optimal resolution.
On-site and telephonic case management is a professional service provided by nurses and vocational counselors to coordinate care, rehabilitation, and vocational services in order to achieve optimal outcome for recovery, disability management, and return to work for the assigned client.
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| Responsibilities: |
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Requirements for the position:
License RN
3-5 years clinical nursing experience
2-3 years of case management
1 yr field based case management experience, preferred not mandatory.
Desired attributes for the position:
General knowledge of and interest in the insurance industry.
Related clinical experience, i.e. occupational health nurse, rehabilitation nurse, neurological or orthopedic experience, OR or Trauma experience helpful.
Certification in relevant professional organization, CCM, CDMS, CRC, COHN, and CRRN or working toward.
Membership in relevant professional organization(s).
Very Flexible, able to maintain a dual accountability.
Organized, computer proficient, ability to multi-task.
Knowledge needed to effectively case manage:
Awareness of professional code of conduct required of nurses in general, and specific codes identified by the Case Management Society of America (CMSA).
Awareness of the requirements established by The MBN and The MDWCC to maintain the WCCM.
General knowledge of the worker’s compensation jurisdictional requirements for medical care and rehabilitation support.
General knowledge of the benefits provided by the worker’s compensation carrier.
General knowledge of private and public sector benefits that might need to be coordinated to assure optimal care is provided.
Sources to assess standards of care, critical pathways, and outcome expectations.
The process of case management:
Accept a referral, review it with the account, and assess for appropriateness.
Introduce self and explain role to the assigned client and his/her representatives.
Complete all required documentation and notifications.
Perform a standard assessment with the client for the following: injury, diagnostics, treatment, response to care, disability, rehabilitation, normal work, and activity routines.
With the client’s permission, obtain updates and recommendations from the treatment team, physician, therapist, etc.
Contact the employer to discuss the options and potential for return to work during the recovery phase, and with potential disability.
Establish patient oriented goals and a plan of action to achieve those goals.
Monitor the patient’s progress; re-evaluate and re- assess the goals and plan.
Maintain a patient-centered approach, and advocate for efficient and effective care.
Communication processes:
Provide a bi- monthly report with frequent verbal and e-mail updates to assure understanding and support of the plan of care.
Educate the patient primarily, but also all stakeholders who need information to make decisions about the care and rehabilitation; including claim specialist, attorneys, employers, and vocational counselors.
Utilize tools of the industry to communicate, such as job analyses and functional capacity evaluations.
Remain non–judgmental as claimants make choices that seem contrary to their progress, but utilize teaching and behavioral techniques as well as re-enforcements to encourage optimal participation in recovery and disability management.
Be sensitive to cultural differences and educational limitations that may effect understanding.
Recognize the common interest and conflicts of the stakeholders in patient care.
Utilize collaborative skills and persistence to achieve a win-win outcome for the client.
Recognize privacy issue when working with the various stakeholders.
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| Key Words: |
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| Contact: |
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Admin |
| Company: |
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BestHeadhunters.com |
| Experience: |
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3 Year(s) |
| Job code: |
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1139 |
| Posted on: |
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08 - 09 - 2010 |
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