Field Nurse Case Manager - Greater Pittsburgh

Opus Medical; Pittsburgh (Allegheny County); A distancia; USD 65.000 - 95.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive pay

Bonus program

Health benefits

Retirement plan

Flexible scheduling

Nurse referral

CE support

Descripción de la vacante

Opus Medical is seeking a Nurse liaison to coordinate care and communicate pertinent medical information among the Injured Worker, the Insured, and the Carrier to facilitate treatment, rehabilitation, and return to work. This is a remote, field-based role with regular local travel up to 2 hours in your region.

Responsibilities include following the Case Management plan, accepting referrals, scheduling assessments, maintaining ongoing communication, and documenting data in CaseAnyplace.

Formación

• Must be a registered nurse with current, unrestricted license in applicable states.
• Able to perform independent assessments within scope.
• Education includes nursing degree and ongoing CE requirements.
• Certification (e.g., CCM, CRC, CLNC, CRRN) within 4 years of hire is preferred.
• Two years of full-time direct case management experience for injured workers or equivalent supervised experience.

Responsabilidades

• Coordinate care and communicate medical information among injured worker, insured, and carrier.
• Schedule assessments and coordinate physician appointments per CM plan.
• Maintain ongoing communication after appointments and record data in CaseAnyplace.
• Attend physician visits and report diagnosis, prognosis, treatment plan, and RTW estimates.
• Assist with RTW planning and provide information to defense attorneys as needed.
• Promote teamwork and maintain compliant licensure and annual training.

Conocimientos

Communication skills

Translation

Educación

Nursing degree (RN)

Continuing education (CE)

Herramientas

CaseAnyplace

Descripción del empleo

Job Summary

Nurse liaison who coordinates care and communicates pertinent medical information among the Injured Worker, the Insured, and the Carrier to facilitate appropriate treatment, successful rehabilitation, and return to work. Delivers efficient, cost-effective communication for work injuries, MVAs, liability claims, LTD/STD, and other referred services. This is a remote, field-based role that involves regular local travel of up to 2 hours in your region.

Duties & Responsibilities

• Follow all policies/procedures in the Case Management (CM) plan; retain accountability for the CM process.

• Accept referrals as assigned by the Director of Case Management.

• Make initial contacts per CM plan; schedule initial assessment; obtain date of next physician appointment.

• Confirm assignment with referral source; clarify special handling instructions.

• Build professional relationships with clients; treat claimants with dignity.

• After physician appointments, contact Carrier and Insured per protocol; maintain ongoing communication with Injured Worker, Insured, and Carrier.

• Record data and billing in CaseAnyplace; submit timely monthly reports (Preliminary, Initial, Progress, Closing).

• Attend physician appointments; obtain diagnosis, prognosis, treatment plan, rehab length, estimated RTW (modified/regular duty), and MMI/Full Recovery as appropriate.

• Refer to Vocational Counselor for job analyses (modified/regular duty) when appropriate and approved by Carrier.

• Recommend IME physicians; coordinate and attend IMEs.

• Coordinate transportation as needed.

• Provide translation as needed (for bilingual nurses).

• Monitor treatment plan; attend therapy sessions when appropriate; maintain contact with therapists for updates.

• Request transfer of files to Vocational Counselor when appropriate (LMS, Voc Rehab).

• Assist Carrier/Insured with RTW planning (modified or regular duty).

• Provide information to Defense Attorneys as appropriate.

• Promote teamwork with all staff members.

• Maximize accurate, appropriate billable hours per monthly target (8 hrs/day).

• Maintain licensure/certifications; complete required annual training on time.

• Perform additional professional duties as assigned.

• Retain responsibility for tasks delegated to non-clinical staff.

Qualifications

• Registered Nurse: Current, unrestricted state license; licensed in each state where field case management is provided; able to perform independent assessments within scope.

• Discipline Eligibility: Practices in a U.S. state/territory allowing independent assessment within scope of practice.

• Education: Completion of a nursing program and ongoing CE as required.

• Certification: One or more national certifications within 4 years of hire (e.g., CCM, CRC, CLNC, CRRN) preferred.

• Experience: Two years FTE direct case management for injured workers or two years under supervision preferred.

Benefits

• Competitive pay and bonus program

• Health, dental, vision, and retirement plans

• Flexible scheduling

• Nurse referral program

• Continuing education support