Field Case Manager-Medical (WC)
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.
- 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.
- Interviews patient?s in their homes; work-sites; or physician?s office to provide ongoing case management services.
- Monitors patient progress toward desired outcomes through assessment and evaluation.
- Communicates both in-person and telephonically with patient; medical providers; attorneys; employers and insurance carriers. Prepares all required documentation of case work activities.
- May arrange referrals; consultations and therapeutic services for patients. Confers with specialists concerning course of care and treatment.
- Develops and administers educational and prevention programs.
- 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.
- Testifies as required to substantiate any relevant case work or reports.
- Performs other duties as assigned.
- Registered nurse with current state RN license.
- Previous (3 or more years) case management experience required.
- Bachelor's degree or equivalent experience preferred.
- CCM; CRRN; COHN; or CDMS eligibility or current certification encouraged. These designations are required where dictated by state law.
- Knowledge of laws and regulations governing delivery of rehabilitation services.
- Knowledge of workers? compensation and disability industry
- Strong problem solving and analytical skills.
- Ability to work independently (may require working from home).
- Demonstrated PC skills (may require the use of a laptop computer).
- Regular local travel required.
- Demonstrated communication; 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: Reno, NV, US
Organization: 43000 - CHC Workers Compensation
Job Posting: 2012-11-08 00:00:00.0
Job ID: 1210633
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...