Workers Compensation Nurse Case Manager

Summit Medical Group; United States; Remote; Full time

Job summary

A leading health care organization is seeking a Case Manager for managing Workers’ Compensation and First Aid cases remotely. This role entails rigorous evaluation of injury reports, communication with healthcare providers, and ensuring optimal management of work-related injuries. Ideal candidates have an LPN or RN license and strong organizational skills, ready to contribute to an evolving care environment.

Benefits

Medical Insurance

Dental Insurance

401k Savings Plan

Life Insurance

Disability Insurance

Vision Insurance

Qualifications

• Candidates must have a valid LPN or RN license.
• Knowledge in Workers’ Compensation case management is preferred.
• Strong verbal and written communication skills are essential.

Responsibilities

• Review Workers’ Compensation cases for management and return-to-work optimization.
• Communicate with patients, employers, and medical providers professionally.
• Gather data on employer outcomes and lost time case goals.

Skills

Communication

Multitasking

Attention to Detail

Education

LPN or RN license

Bachelor Degree

Tools

Athena (EMR)

Salesforce (CRM)

Job description

About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians .

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all.We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

Job Purpose: The individual employed in this position will be responsible for reviewing all Workers’ Compensation and First Aid cases at CityMD and Summit Health to ensure such cases are appropriately managed and that there is return-to-work optimization of all work-related injuries.

Duties and Responsibilities:

The primary duties and responsibilities of the Case Manager are:

• Assess and analyze injured workers’ Post Injury Evaluation Reports — disability status is supported by diagnosis, work status and restrictions is appropriate, and documentation is correct/complete.
• Access database to reference client (employer) modified duty policy and ensure Post Injury Evaluation Reports meets client specifications.
• Work with treating medical provider regarding cases that may need attention or require amendment to ensure appropriate handling and consideration of modified duty is applied to facilitate return to work.
• Communicate with patients in a professional and courteous fashion when needed to discuss progress or changes in work / appointment status
• Work with supervising physician to help identify trends in CityMD practice that need modification or attention.
• Transmit employee post injury information to employers via email.
• Conduct calls to employers, adjusters and/or nurse case managers regarding any amendments made to case diagnosis, treatment and/or lost time from work.
• Gather data on employer outcomes and lost time case goals.
• Respond to inquiries (phone calls and emails) from employers, adjusters, nurse case managers and patients regarding cases and work status notes.
• Respond to inquiries from adjusters or payers for documentation or information on Workers’ Compensation cases.
• Learn and be proficient in rules that govern HIPAA and release of medical records to patients, employers, payers, and providers.
• When necessary, coordinate referral appointments with specialists.
• Collaborate with centralized Workers’ Compensation Teams, Occupational Health Support Teams, Sales Team and Clinical Operations Teams to resolve issues and ensure the highest level of customer satisfaction.
• Work closely with other departments including but not limited to Referral Management, Aftercare, Medical Records, Compliance, and Billing with the goal of ensuring that CityMD-Summit Health is providing high quality and appropriate care to all work-related injury patients and ensuring seamless operation processes for customer experience.

Qualifications:

A candidate’s qualifications will include:

• LPN or RN license required
• Bachelor Degree preferred
• Workers’ Compensation case management experience preferred
• Must be able to understand basic medical terminology and recognize basic nature of diagnosis as provided by treating physician
• Understanding of basic multispecialty terminology, including orthopedic diagnoses and diagnostic testing, preferred
• Excellent verbal and written communication skills
• Strong multitasking and organizational skills
• High attention to detail
• Experience in the following systems preferred: Athena (EMR), Salesforce (CRM)

• Ability to work in a fast-paced, ever-changing environment
• Customer orientation and ability to adapt/respond to different types of characters
• Ability to remain professional and courteous with customers at all times
• Works well independently and in a team environment

Additional Information:

• The Case Manager will report directly to the Manager, Employer Concierge Service who may modify these responsibilities and activities to suit the needs of the goals behind the Workers’ Compensation program.
• Available to work 8-hour shifts between 8am-7pm Mondays through Fridays.
• This role is 100% remote.

Direct Reports:

• None

Salary: $35.00 per hour

About Our Commitment Total Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Companyprovides equal employment opportunities ( EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Safety Disclaimer

OurCompanycares about the safety of our employees and applicants.Our Companydoes not use chat rooms for job searches or communications.Our Companywill never request personal information via informal chat platforms or unsecure email.Our Companywill never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at selectOur Companylocations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/ .