RN Telephonic Case Manager - Workers' Comp & Care Impact

Berkley Medical Management Solutions (a Berkley Company); Urbandale (IA); On-site; USD 75,000 - 88,000; Full time

Benefits offered by this job

Health insurance

Dental

Vision

Life insurance

Disability insurance

Wellness program

Paid time off

401(k)

Profit sharing

Job summary

Berkley Medical Management Solutions (BMMS) is seeking an experienced Registered Nurse to coordinate medical case management and support a timely return-to-work for injured workers.

You will communicate promptly with employers, adjusters and physicians, assess treatment utilization, review records, and manage caseloads across states to ensure cost-effective, quality care. This RN role requires a valid license and CCM preference, with bilingual English/Spanish considered a plus.

Qualifications

• Exhibit strong communication skills, professionalism, flexibility and adaptability.
• Oral and written fluency in both Spanish and English a plus.

Responsibilities

• Coordinate and implement medical case management to facilitate case closure
• Timely and comprehensive communication with employers, adjusters and the injured workers
• Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
• Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
• Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
• Acquire and maintain nursing licensure for all jurisdictions as business needs require
• Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
• Document activities and case progress using appropriate methods and tools following best practices for quality improvement
• Reviewing job analysis/job description with all providers to coordinate and implement disability case management. This includes coordinating job analysis with employer to facilitate return to work.
• Engage and participate in special projects as assigned by case management leadership team
• Occasionally attend on site meetings and professional programs
• Foster a teamwork environment
• Maintaining and updating evidence based medical guidelines (such as Official Disability Guidelines, MD Guidelines and all required state regulated guidelines) in reference to the injured worker treatment plan and work status.
• Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed.
• Obtain case management professional certification (CCM) within 2 years of hire date
• Earn Continuing Education Units to maintain certifications and licensures

Skills

Communication skills

Flexibility

Adaptability

Bilingual (Spanish/English)

Education

RN license

CCM preferred

Bachelor of Nursing preferred

Job description

Berkley Medical Management Solutions (BMMS) is seeking an experienced Registered Nurse to coordinate medical case management and support a timely return-to-work for injured workers.

You will communicate promptly with employers, adjusters and physicians, assess treatment utilization, review records, and manage caseloads across states to ensure cost-effective, quality care. This RN role requires a valid license and CCM preference, with bilingual English/Spanish considered a plus.