Specialty Nurse Case Manager - Telephonic
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POST DATE 9/14/2016
END DATE 10/28/2016
JOB DESCRIPTIONCNA Insurance has an opening for an experienced Telephonic Medical Nurse Case Manager in the Workers Compensation specialty area. This is an inside position in our Syracuse, NY, Wyomissing, PA, Warren NJ, or Pittsburgh, PA offices. The individual will make assessments and determinations applying various case and disability management principles within area of specialty. Ensures expeditious and effective claims decisions through collaboration with healthcare providers, employers, claimants and claims staff.
ESSENTIAL DUTIES & RESPONSIBILITIES
1. Assesses disability status makes recommendations and identifies appropriate resources.
2. Gathers and coordinates medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and addresses length of disability.
3. Consults on case management issues in area of specialty and applies effective case management interventions.
4. Works with medical and other providers to ensure appropriate treatment and return to work.
5. Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements.
6. Addresses causality and refers to appropriate medical expertise.
7. Documents according to jurisdictional, departmental and accreditation requirements.
SKILLS, KNOWLEDGE & ABILITIES
1. Strong knowledge of case management and insurance industry preferred but willing to train if other skills met.
2. Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service.
3. Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise and effective manner.
4. Strong interpersonal skills with the ability to effectively interact with internal and external business partners.
5. Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks.
6. Knowledge of Microsoft Office Suite as well as other business related software.
7. Ability to work independently.
EDUCATION & EXPERIENCE
1. Current unrestricted RN license required.
2. Minimum 3 to 5 years diverse clinical background. Case management or disability management experience required. Workers Compensation experience strongly preferred.
3. Bilingual candidates would be ideal.
4. Certified Case Management (CCM) required or the ability the sit for the exam within 1st year of hire. Additional certifications would be preferred such as, Certified Disability Management Specialist (CDMS), Certified Occupational Health Nurse (COHN), or Certified Rehabilitation Nurse (CRN).
Primary Location: United States-New York-Syracuse
Other Locations: United States-New York-Syracuse
Organization: Claim-CommFld-Workers Comp 2-2
Job Posting: Oct 5, 2016
Unposting Date: Ongoing.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.