GENERAL SUMMARY :
Responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs
required to facilitate the patient’s appropriate and timely return to work. Acts as a liaison with patient/family,
employer, provider(s), insurance companies, and healthcare personnel.
Ø Assesses and analyzes an injured employee’s medical and vocational status. Develops a plan of care to
facilitate the patient’s appropriate and timely return to work.
Ø Interviews patient’s in their homes, work-sites, or physician’s office to provide ongoing case management
Ø Monitors patient progress toward desired outcomes through assessment and evaluation.
Ø Communicates both in-person and telephonically with patient, medical providers, attorneys, employers
and insurance carriers. Prepares all required documentation of case work activities.
Ø May arrange referrals, consultations and therapeutic services for patients. Confers with specialists
concerning course of care and treatment.
Ø Develops and administers educational and prevention programs.
Ø Applies all laws and regulations that apply to the provision of rehabilitation services. Applies all special
instructions required by individual insurance carriers and referral sources.
Ø Testifies as required to substantiate any relevant case work or reports.
Ø Performs other duties as assigned.
Ø Registered nurse with current state (New Mexico) RN license.
Ø Previous (3 or more years) case management experience required.
Ø Bachelor’s degree or equivalent experience preferred.
Ø CCM, CRRN, COHN, or CDMS eligibility or current certification encouraged. These designations are
required where dictated by state law.
Ø Knowledge of laws and regulations governing delivery of rehabilitation services.
Ø Knowledge of workers’ compensation and disability industry
Ø Strong problem solving and analytical skills.
Ø Ability to work independently, requires working from home office.
Ø Strong computer skills with MS Office: Word, Excel and Outlook. Requires the use of a laptop computer and smart phone. Able to complete automated files.
Ø Regular, daily local travel required.
Ø Professional communication skills both written and verbal. Bi-lingual in Spanish is preferred.
Good time management, organizational, and interpersonal skills.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Primary Location: Albuquerque, NM, US
Other Locations: ,
Organization: 43000 - CHC Workers Compensation
Job Posting: 2013-01-24 00:00:00.0
Job ID: 1310283
Coventry Health Care - 19 months ago
In May of 2013, Coventry became a part of Aetna. We are excited to join together with common values and a common mission: empowering people...