Field Nurse Case Manager - Greater Pittsburgh

Opus Medical; United States; Remoto; USD 75.000 - 95.000; Tempo pieno

Vantaggi offerti da questo lavoro

Competitive pay and bonus program

Health, dental, vision, and retirement

Flexible scheduling

Nurse referral program

Continuing education support

Descrizione del lavoro

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

You will follow the Case Management plan, accept referrals, schedule assessments, maintain stakeholder communications, and document data for billing and reports, ensuring compliant, cost-effective care.

Competenze

• Current, unrestricted RN license in applicable states.
• Two years of full-time direct case management experience preferred.
• Certifications such as CCM/CRC/CLNC/CRRN are preferred within 4 years of hire.

Mansioni

• Follow Case Management plan; retain CM process accountability.
• Accept referrals from Director of Case Management.
• Schedule initial assessments and obtain next appointment dates.
• Coordinate with referral sources and clarify handling instructions.
• Build professional relationships with clients and treat claimants with dignity.
• Maintain ongoing communication with Injured Worker, Insured, and Carrier after physician visits.
• Record data and billing in CaseAnyplace; submit monthly reports.

Conoscenze

Registered Nurse

Independent assessments

Field case management

Two years case management

Formazione

Nursing program completion

Continuing education CE requirements

Descrizione del lavoro

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