Occupational Health Case Manager

Advocate Health; Neenah (WI); On-site; USD 70,000 - 95,000; Full time

Job summary

Advocate Health in Wisconsin seeks a Registered Nurse Case Manager to educate employers and injured employees, interpret care plans, and advocate for timely, evidence-based treatment. You will assess medical histories, plan care, and collaborate with multidisciplinary teams to support recovery and safe return to work.

The role requires an RN license, an Associate's Degree in Nursing, and about three years of clinical nursing experience.

Qualifications

• RN license issued by the state in which the team member practices.
• Associate's Degree in Nursing.
• Typically requires 3 years of experience in clinical nursing.
• Knowledge of injury care management and workers' compensation.
• Excellent analytical and interpersonal communication skills.

Responsibilities

• Educates employer and injured employee on conditions, treatments and care plans.
• Uses nursing assessment and clinical reasoning to develop a plan of care for recovery and return to work.
• Coordinates seamless, evidence-based care across the care continuum.
• Supports patient and family with education, psychosocial needs, and continuity of care.
• Collaborates with providers to expedite care and modify plans as needed.
• Facilitates communications among patient, family, physicians, and staff.
• Identifies barriers to care and discharge and acts to resolve them.
• Collects data on outcomes and utilization for reporting.
• Ensures documentation supports timely service provision.

Skills

Analytical skills

Interpersonal communication

Negotiation

Return-to-work interventions

Microsoft Office

Education

Associate's Degree in Nursing

Tools

Microsoft Office

Job description

Major Responsibilities:

• Serves as an educator and resource to the employer and injured employee, which includes but not limited to providing health education to enhance the understanding of conditions, treatments and/or procedures and interpreting the care plan and medical results.
• Uses nursing assessment and clinical reasoning skills to assess patient's medical history, current conditions, and response to treatment to develop a plan of care that helps patient progress reasonably through recovery to reach end of healing and return to work. Collaborates with multidisciplinary team and other departments to develop plan of care. If patient is unable to return to work, uses clinical judgment to provide recommendations for disposition, partnering with the physician.
• Coordinates timely, seamless, evidenced based care across the care continuum resulting in best patient outcomes. Ensures smooth transitions between care settings. Uses nursing expertise to help patient navigate through subsequent treatment and follow up.
• Supports the patient and family by providing education, addressing psychosocial needs, advocating, providing continuity of care and identifying barriers to care.
• Collaborates with providers regularly and ongoing regarding patient care plan. Makes suggestions in expediting care and makes modification to a tentative plan on a timely basis, if necessary.
• Facilitates communications between and negotiates with the patient/family, physicians, nurses, dietary, rehabilitation, and other disciplines that need to collaborate to provide care for the patient.
• Identifies, evaluates, and acts to resolve any potential barriers to delivery of care and a timely and appropriate discharge.
• Collects accurate data on outcomes and resource utilization issues and facilitates reporting of utilization monitoring/review activities to the appropriate committees/persons.
• Works closely with the medical staff, hospital departments and ancillary services in expediting care delivery and appropriate documentation to avoid delays in timely service provision. Validates care that is provided.
• Promotes effective professional relationships with physicians, other department members and hospital staff; facilitates problem solving, as appropriate.
• Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.

Licensure, Registration, and/or Certification Required:

• Registered Nurse license issued by the state in which the team member practices.

Education Required:

• Associate's Degree in Nursing.

Experience Required:

• Typically requires 3 years of experience in clinical nursing.

Knowledge, Skills & Abilities Required:

• Position requires working knowledge of the components of quality and patient care needs specifically related to injury care management and knowledge of workers compensation.
• Excellent analytical and interpersonal communication skills necessary to negotiate with families, patient, physicians and third party payers for optimum plan.
• Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.
• Demonstrated ability to take the initiative in responding to employers, communicating with providers to create a clear and concise picture of the injured employee's recovery process.
• Must have the ability to make suggestions on interventions that will expedite employee's return to work.
• Intermediate computer skills including experience in using Microsoft Office (Excel, PowerPoint and Word) or similar products.

Physical Requirements and Working Conditions:

• Exposed to normal office and clinical environment.
• Must be able to sit for majority of the workday; stand and walk for the equivalent of several blocks at a time.
• Must lift up to 10 lbs. continuously, up to 20 lbs. frequently, and up to 50 lbs. occasionally.
• Must have functional speech, vision, hearing, and touch with ability to use fine-hand manipulation skills.
• May be exposed to the following hazards: mechanical, electrical, chemical, blood and body fluids; therefore protection clothing and equipment must be worn as necessary.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.