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SGS-Medical Case Manager

Remote: 
Full Remote
Contract: 
Full time
Work from: 
Massachusetts (USA)

Offer summary

Qualifications:

Bachelor's in Science Nursing or Associate in Nursing (ASN) or Nursing Diploma required., Active RN license in the state of residence and must be a US citizen., 3+ years of clinical experience as a Registered Nurse and 2+ years in medical case management or related fields., Proficiency in Microsoft Office and strong communication and organizational skills are essential..

Key responsibilities:

  • Coordinate treatment pathways for claims meeting internal case management criteria.
  • Document case management plans and conduct assessments of injured workers/employees.
  • Collaborate with various stakeholders to facilitate return-to-work plans and manage disability duration.
  • Identify and recommend strategies for vocational rehabilitation services and maintain compliance with quality management programs.

ICONMA logo
ICONMA Human Resources, Staffing & Recruiting Large https://www.iconma.com/
1001 - 5000 Employees
See all jobs

Job description

Our Client, a Business Solutions company, is looking for a SGS-Medical Case Manager for their Remote location.
 
Responsibilities:
  • Responsible for coordinating the treatment pathways of those claims that meet the internal case management criteria, including setting the appropriate treatment plan and other activities that meet an injured worker's/employee's health and return-to-work needs or other productive activity.
  • Understands and implements criteria for identifying individuals for case management services
  • Coordinates case management plans and activities with the human resources department of the injured worker/employee, as appropriate
  • Solicits the employee's interest and consent, if necessary, for participation in case management activities and documents oral and/or written consent
  • Documents a case management plan specific to the injured worker/employee that includes short and long term goals with timeframes, timeframes for re-evaluation, resources to be utilized, and collaborative approaches to be used (including physician participation)
  • Conducts and documents an assessment of each injured worker/employee including (as appropriate) health status, treatment plan, financial resources for health care, psychosocial status, consumer knowledge, education needs in relation to health status and treatment plan, past relevant history, and possible non-medical impediments to successful resolution
  • Responsible for managing the disability duration of an injured worker/employee and focus on return to work opportunities or other productive activity, including working with medical providers to identify an estimated return to modified duty, vocational rehabilitation, release from care, or actual return-to-work date
  • Collaborates and clearly communicates with the injured worker/employee, family members, providers, employer, or the employer's representative in the execution of a plan for return-to-work or other productive activity. · Identifies and obtains any required or outstanding medical documentation in support of the individual's plan for a return-to-work or other productive activity.
  • Understands and implements criteria for discharge of injured worker/employee or termination of case management services
  • Promotes goodwill by assisting all involved parties on issues related to the injured worker/employee, provider relations, and OWCP coordination, as applicable.
  • Identifies, evaluates, and recommends strategies for claims where vocational rehabilitation services may produce an eventual return-to-work; interfaces with vocational rehabilitation or other specialties as appropriate and applicable.
  • Understands the organization's quality management program and the case manager's role within that program
  • Experience with Federal Employee Compensation Act (FECA) and FECA related issues preferable, as applicable for assigned account(s).
  • Is an effective team member; supports the team by pitching in at any level and effectively working across the organization to meet the needs of the business
  • Takes ownership of personal actions and outcomes; encourages and empowers others to do the same
  • Embraces change; maintains an open mind and is flexible and adaptable in the face of ambiguity and change
  • Ability to work independently, multitask, and adjust priorities · Proactively seeks opportunities to increase knowledge, skills and abilities
  • May perform other duties, as needed, to meet the needs of the business
 
Requirements:
  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to sit, talk, and hear.
  • The employee frequently is required to use the fingers to make small movements such as typing, picking up small objects, or pinching fingers together
  • The employee is occasionally required to walk; reach with hands and arms; stoop, kneel, crouch, or crawl. Sedentary work.
  • Sitting most of the time.
  • Specific vision abilities required by this job include close vision, peripheral vision, depth perception, and the ability to adjust focus.
  • An employee in this position may lift, carry, push, and/or pull objects weighing up to 10 lbs.
  • Occasionally but rarely may move objects weighing up to 20 lbs.
  • The employee holding this position must have strong communication and organizational skills, and an ability to interact and work with others. They must be able to work under time constraints and deadlines.
  • Bachelors in Science Nursing or Associate in Nursing (ASN) or Nursing Diploma.
  • The Medical Case Manager role does require an active RN license in the state they live in and must be a US citizen. National certification in case management or related field preferred.
  • Must Have Unrestricted Current Massachusetts and Compact State Registered Nurse License, We need to have a record of RN Licenses for all Medical Case Managers submitted with their new hire paperwork.
  • 3+ years of clinical experience as a Registered Nurse
  • 2+ years experience in medical case management, discharge planning, utilization review/management to determine the necessity of medical services, occupational health, and/or comparable field
  • Experience in Behavioral Health Chronic Medical Conditions or Oncology preferred,
  • Proficiency in Microsoft Office and Computer proficiency
  • Coordination and Service Delivery
  • Appreciate and comply with all confidentiality requirements
  • Be proficient in how to obtain and document an accurate medical history
  • Be skilled in developing treatment plans with realistic goals
  • Understand information systems and data management
 
Why Should You Apply?  
As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.
 

Required profile

Experience

Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Case Management SystemsTreatment PlanningNurse Licensure CompactClinical AssessmentsData ManagementDischarge PlanningOccupational HealthUtilization ManagementBusiness Process ImprovementTraining AnalysisOncologyBehavioral HealthCase Management SystemsChronic Diseases

Other Skills

  • Microsoft Office
  • Communication
  • Multitasking
  • Teamwork
  • Organizational Skills
  • Physical Flexibility
  • Problem Solving
Are you interested?

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