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Medical Case Manager
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LOCATION: Miami, FL
If you are a Registered Nurse seeking a better work/life balance and the opportunity to work with a company that provides growth opportunities then Broadspire may be a great fit for you!
We value our Registered Nurses and will encourage your passion for healthcare and your life! We help people get their lives back and as a Medical Case Manager with Broadspire you will be an inspiration to the injured the injured clients you will work with.
* This position requires No Weekends! No Evenings! and No ShifTs!
* You will be able to work from home with full-time benefits and bonus opportunities!
* And this is a 40 hour benefited position that is not based on case load!
As a Medical Case Manager with Broadspire you will have the rewarding opportunity to provide quality case management services in an appropriate, cost effective manner. Provide medical case management service which is consistent with Utilization Review Accreditation Commission standards and Case Management Society of America Standards of Practice and Broadspire Quality Improvement Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers' Compensation, Group Health, Liability and Disability.KEYWO
This is a "work from home" position requiring local field case management travel.
Here is more of what you will be doing:
* Review case records and reports, collects and analyzes data, evaluates client's medical status and defines needs and problems in order to provide proactive case management services.
* Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate rehab goals and return to work.
* Demonstrate ability to meet administrative requirements, including productivity, time management and quality improvement standards, with a minimum of supervisory intervention.
* May perform job site evaluations/summaries to facilitate case management process.
* Facilitate timely return to work date by establishing a professional working relationship with the client, physician, and employer. Coordinate return to work with patient, employer and physicians.
* Maintain contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for case management for the client.
* May obtain records from the branch claims office.
* May review files for claims adjusters and supervisors.
* May meet with employers to review active files.
* Peer reviews and independent medical examinations by obtaining and delivering medical records and diagnostic films, notifying patients and conferring with physicians.
* Utilize experience and medical resources to interpret medical records and test results and provides assessment accordingly.
* Travel to homes, health care providers, job sites and various offices as required facilitating return and resolution of cases. (Approximately 70% of a Medical Case Manager's position is spent in local travel.)
* Meet monthly production requirements and quality assessment requirements to ensure a quality product.
* Review cases with supervisor monthly to evaluate files and obtain directions.
OFFICIAL JOB TITLE: Medical Case Manager
Here is what you will bring to Broadspire:
* An RN and Driver's License in good standing
* An Associate s degree in Nursing
* Three (3) years of clinical Nursing experience preferably in Orthopedics, Neurology, Intensive Care, Occupational Medicine, or related health care discipline.
* Your general working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
* Your excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
* Demonstrate your ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.
It would be a bonus for Broadspire if you have:
* Bachelor's Degree in Nursing (BSN)
* CCM, COHN, CRRN or CDMS certification
* Bilingual Spanish a plus but not required
Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the
United States. Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the
United Kingdom (www.BroadspireTPA.co.uk).
In addition to a competitive salary, Broadspire offers you:
* Competitive Salary plus Bonus Opportunities with a 40 hour benefited position that is not based on case load
* Great Work/Life Balance having the flexibility to "Work from Home" with full-time benefits
* Strong Benefits Package including Company Car, matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more!
* Career Advancement Potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries
* World Class Training opportunities through every stage of your career
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.