Nurse Case Manager
Chubb Group - Pennsylvania

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For more than 130 years, the Chubb Group of Insurance Companies has been delivering exceptional property and casualty insurance products and services to businesses and individuals around the world.

Today, we are the 10th largest property and casualty insurer in the United States and have a worldwide network of some 120 offices in 26 countries staffed by 10,200 employees. The Chubb Corporation reported $52.2 billion in assets and $13.6 billion in revenues in 2012. According to Fortune magazine, Chubb is the 202nd largest U.S.-based Corporation.

We have emerged as a leader in the insurance industry not only on the basis of our size or our longevity. We consistently strive to build lasting relationships with our customers and 8,500 independent agents and brokers, and we aim to be the best at what we do by delivering unparalleled service and innovative, scalable and specialized products backed by financial strength and third-party endorsements.

Chubb is currently seeking a Nurse Case Manager to join our team in the Philadelphia, PA, office. Remote consideration for appropriate candidate.

JOB SUMMARY: The Nurse Case Manager is responsible for evaluating and expediting appropriate, cost effective medical treatment of injured employees with the goal of optimum medical improvement and early return to work.

POSITION RESPONSIBILITIES:

Receives new assignments from adjusters to evaluate need for case management intervention.
• Review initial investigation report.
• Call injured employee for relevant information on injury, current medical treatment and to inform employee of Case Manager's available assistance.
• Call physician for status of disability, treatment plan and to inform the physician of Case Manager's available assistance.
• Call employer to inform them of employee's current work status, to discuss early return to work options and to advise of Case Manager's available assistance.
• Complete preliminary report for adjuster. Identify appropriate disability duration timeframes. Make recommendations as to further activities and need for continued case management. Proceed as directed by adjuster.
•The Nurse Case Manager is required to be available and participate in claim round tables to discuss medical and disability direction and assist claims staff with recommendations for resolving the claim.
As directed, monitors employee's progress.
• Maintain contact with employee, doctor and employer to ensure timely and accurate information.
• Develop plan of action to facilitate maximum medical recovery. Confer with adjuster, employee and doctor to work within that plan or to make necessary modifications.
• Assist doctor and employee in locating ancillary medical services that may be needed (e.g. physiotherapy, x-rays, etc.). Recommend use of pre-determined PPO providers when appropriate. Sees out alternative providers as warranted.
• Alert adjuster to proposed medical care and possible alternative procedures. As directed by the adjuster, discuss alternatives with the treating physician.
• Make recommendation for the need for onsite case management services based on severity and longevity of case.
Coordinates Early Return to Work Plan.
• Develop action plan for early return to work (RTW). Such a plan must consider not only full duty RTW, but also modified and light duty. Confer with employer, employee, doctor and adjuster to execute the plan and/or determine necessary modifications.
• Update the employer on work status of employee and verifies status of RTW possibilities. Update employee of RTW options.
• Make 24 hour contact with the Employee and Doctor after each medical appointment and provide and update to the Employer within 24-48 hours following the scheduled appointment.
• Assist Claims Department with identifying physicians to treat injured employees, Impartial Medical Examiners and establishing or adding to Preferred Provider Organization. Establish a list of preferred physicians, OT/PT with addresses and telephone numbers.
Maintain billable rate of 35 hours per week.
KNOWLEDGE, SKILLS & ABILITIES:
• Excellent verbal and written communication skills. This position will involve continuous personal, telephone and written contact.
• Strong interpersonal skills.
• Ability to work independently and meet deadlines.
• Demonstrated strong skills in time management, organization and critical thinking.
• Knowledge of traumatic injuries and the resultant disabilities and medical complications.
• Knowledge of the local Worker’s Compensation Act and working knowledge of the medical providers in the assigned territory.
EDUCATION & EXPERIENCE:
• Registered Nurse (RN) license in good standing required.
• Bachelor of Science in Nursing (BSN) preferred.
• Pennsylvania Registered Nurse (RN) license in good standing preferred or ability to obtain license in 3-6 months after starting.
• Certified Case Manager (CCM) certification required or eligible to sit for exam.
• CDMS (Certified Disability Management Specialist) and/or CRRN (Certified Rehabilitation Registered Nurse) may be considered depending on experience, training and knowledge.
• Minimum 3 year experience in the Medical Management field required.
Chubb prides itself on the ability to provide all employees with an extraordinary work environment which promotes teamwork, diversity and incentives for those who exceed expectations. Chubb has been recognized as one of the top 50 companies for diversity by Diversity Inc. magazine, one of America’s most admired companies by Forbes, and one of the top 100 companies to work for by Fortune.
Chubb's compensation and benefit plans work together to create a Total Rewards Program for our employees that is among the best in our industry. As a global organization, we work hard to achieve our goal of providing flexible and competitive compensation and benefits packages in each local market in which we operate. Our goal is to exceed average market practices for our performers. For more information about Chubb and our benefits, visit our website at www.chubb.com.
Chubb & Son, Inc., a division of Federal Insurance Company, does not accept resumes from unsolicited third party agencies or recruiters. No fees will be paid to third parties who submit unsolicited candidates in this manner.

Chubb Group - 14 months ago - save job
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