Medical Case Manager - Remote / Telecommute

Cynet Systems Inc; Bethesda (MD); Remote; USD 70,000 - 82,000; Full time

Job summary

A leading company is seeking a Case Manager to provide support for injured workers, coordinating communication and assessment to facilitate their return to work. The ideal candidate will possess a Bachelor of Science in Nursing and have significant case management experience, particularly in the context of workers’ compensation. This role emphasizes team collaboration, exceptional communication skills, and proficiency in electronic management systems and Microsoft applications.

Qualifications

• National certification in case management preferred.
• 5 years related clinical experience required.
• Experience in the workers' compensation arena is vital.

Responsibilities

• Coordinate timely contact and information sharing with injured workers.
• Conduct assessment of injured workers including clinical and non-medical obstacles.
• Collaborate with stakeholders to execute plans for return to work.

Skills

Excellent verbal communication

Written communication skills

Organizational skills

Analytical skills

Customer service skills

Proactive problem-solving

Education

Bachelor of Science in Nursing

Tools

Microsoft Office

Job description

Job Description:

Pay Range: $34hr - $39hr

Responsibilities:

• Accepts assignments based on referrals from DOL with service period limitations
• Responsible for coordinating timely contact and information sharing with the injured worker, treating provider, and Agency.
• Accurate, timely, documentation of contact attempts and communications in assigned case management systems as identified by SGS as well as DOL.
• Conduct and document an assessment of each injured worker/employee including (as appropriate) regarding clinical and non-medical obstacles sychosocial status, consumer knowledge, education needs in relation to health status and treatment plan, past relevant history, and possible non-medical impediments to successful resolution.
• Collaborate and clearly communicate with the injured worker/employee, providers, employer, or the employer's representative in the execution of a plan for return to work or other productive activity.
• Identify and obtain any required or outstanding medical documentation in support of the individual's plan for a return to work or other productive activity.
• Understand and implement criteria for discharge of injured workers from TN services.
• Identify cases that would benefit from additional case management services, such as assignment of a DOL FN.
• Promote goodwill by assisting all involved parties on issues related to the injured worker/employee, provider relations, and OWCP coordination, as applicable.
• Understand the organization's quality management program and the case manager's role within that program.
• Is an effective team member; supports the team by pitching in at any level and effectively working across the organization to meet the needs of the business.
• Take ownership of personal actions and outcomes.
• Embrace change; maintain an open mind and be flexible and adaptable in the face of ambiguity and change.
• Ability to work independently, multitask, and adjust priorities.
• Proactively seek opportunities to increase knowledge, skills, and abilities.
• May perform other duties, as needed, to meet the needs of the business.
• Ability to utilize a case management system, Electronic Medical Record or other electronic platform.
• Ability to utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.
• Demonstrated ability to use Microsoft applications and demonstrate basic electronic technology understanding.
• Computer literacy, including MS Word, Excel, and Outlook.

Certification:

• National certification in case management or related field preferred in one of the following areas: Occupational Health (COHN); Case Management (CCM), Insurance Rehabilitation (CIRS/CRRN), Disability Management (CDMS), and/or Nurse Case Manager Board Certified (ANCC/ANA).

Education:

• Bachelor of Science in Nursing preferred.

Experience:

• 5 years related clinical experience with a minimum of two years adult medical/surgical nursing experience and a minimum of two years case management experience in the workers’ compensation arena OR, have a minimum of one year of adult medical/surgical nursing experience and three years of case management experience in the workers’ compensation arena.
• Experience with Federal Employee Compensation Act (FECA) and FECA-related issues preferable, as applicable.

Communication Skills:

• Excellent verbal, written, and interpersonal communication skills, and organizational and analytical skills.
• Superior customer service skills working proactively and collaboratively with client employees and client leaders, medical staff, and co-workers.
• Ability to effectively present information.
• Excellent team player; ability to partner with internal and external clients and other cross-functional departments.
• Superior writing and communication skills.
• Utilizes direct communication and proactive problem-solving to address challenges and disagreements.

Reasoning Ability:

• Ability to apply logical thinking to a wide range of intellectual and practical problems.
• Able to deal with very difficult concepts and complex variables.
• Ability to comprehend, analyze, and interpret documents.
• Ability to solve problems involving several options in situations.
• Requires intermediate analytical and quantitative skills.

Other Skills and Abilities, Qualifications:

• Proficiency in Microsoft Office.