Remote Opportunity within the US
The Nurse Case Manager (NCM) is responsible for applying medical knowledge in reviewing workers’ compensation claims to assess, evaluate, plan, implement and oversee the treatment appropriateness for occupational injuries based upon evidence based guidelines. The NCM utilizes clinical knowledge to evaluate the medical and disability needs of an injured worker against relevant policies, facilitate coordination of the patient’s medical treatment and timely return to work. The NCM engages the claimant and physician(s) in providing proactive medical and disability management, working collaboratively with claim handlers in providing focused claim resolution and return to work driven outcomes. The case management process requires a focus on customer service, skills, knowledge of setting appropriate goals and measuring outcomes to effectively ensure optimal outcomes.
The nurse case manager must be able to demonstrate and be accountable for the standards of practice policies and procedures, quality assurance and the goals of the organization. Also, manage treatment of claimants through the workers’ compensation system based on the individual’s diagnosis and state workers’ compensation regulations.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
Registered Nurse license active and unrestricted required. Bachelor’s degree in Nursing (BSN) preferred. Continuous learning required, as defined by the Company’s learning philosophy. Certification or progress toward certification is highly preferred and encouraged.
Three years active patient or clinical care experience as a Registered Nurse required. Three years workers’ compensation case management, occupational health, rehabilitation or insurance experience preferred.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
Work is performed in an office/remote setting with no unusual hazards. Minimal travel.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
“Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $59,600 and $99,700.”
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
At Emergent Holdings, we’re inspired to create, to challenge the status quo, to think not just about what our customers need now, but what they will need in the future.
We are strategic thinkers.
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We are market trendsetters.
Together, we are Emergent Holdings.
Our diverse team of established industry experts embraces a culture of innovation and entrepreneurial spirit.
That means we’re focused on innovation, on leading and shaping our markets and improving health and safety for our customers and communities. For our customers, the result is a suite of solutions, services and products delivered ahead of market needs — and in anticipation of member demands.
We are tireless in our pursuit of the exceptional, and our companies deliver optimal customer experiences and improve people’s lives every day, by making workplaces safer and delivering affordable, solutions-focused healthcare services.