Job Description
As our Telephonic Nurse Care Manager, you will coordinate all aspects of patient care for high-risk individuals. You will evaluate each patient while directing treatment plans, discuss claims, benefits, and eligibility, and manage resources while working alongside patients, their families, and other medical professionals.
- In this job, you will:
- Establish collaborative relationships and act as an intermediary between clients, patients, employers, providers, and attorneys
- Assess, coordinate, implement, monitor, and evaluate the plan to meet the injured/disabled individual’s needs, utilizing the knowledge of medical necessity, care appropriateness, and managed care principles
- Promote quality, cost-effective care throughout the health continuum to ensure the injured/disabled individual is able to return to an optimal level of work and functioning and documenting case savings
- Document ongoing progress of all case management activity, including the organized maintenance of files containing clinical documentation of interactions with all parties of every claim
- Assess injury severity, extent of disability, treatment plans, functional abilities, and physical job requirements to establish return to work plans and strategies to manage future medical exposure
- An RN License preferably in a compact state AND with an IL license
- California RN license a plus
- Full Time – 9:00am CST to 5:30pm CST, with the ability to flex time based on the jurisdiction
- Strong computer skills required – Microsoft Suite (Outlook, Excel, Word, etc.)
- At lest 3 years of TCM experience preferred
- Experience with Workers’ Compensation or Disability Management
- The ability to maintain confidentiality of all information, policies, and procedures
- The ability to set priorities and work both autonomously and as part of a team
- Demonstrated sensitivity to culturally diverse people and situations
- Well-developed time management, organization, and prioritization skills
- Knowledge of utilization management, case management, and healthcare provided throughout the health continuum
- Excellent oral and written communication skills with a heavy focus on customer-service
- The ability to gather data, compile information, and prepare summary reports
- Strong interpersonal and conflict resolution skills
- Experience in a fast-paced, multi-faceted environment
- Demonstrated persistence and attention to detail
- The ability to stay calm during stressful situations
- Having your BSN, CCM, and/or any other insurance/workers’ compensation certifications is a huge plus!
- Associate degree
- Competitive base salary, profit sharing, 401k matching, generous time off, and career growth opportunities
- A relaxed, yet upbeat, work environment
- Rising was named a Top Workplace in the healthcare industry for 2023! Check out our profile here: Rising Medical Solutions, Inc Profile (topworkplaces.com)
- We're on YouTube! Check out our culture at: http://www.youtube.com/user/RisingMedical
- Want to see more? Check out our:
- Facebook: https://www.facebook.com/RisingMedicalSolutions
- LinkedIn: http://www.linkedin.com/company/rising-medical-sol...
- Glassdoor: http://www.glassdoor.com/Overview/Working-at-Rising-Medical-Solutions- EI_IE322608.11,35.htm pages
If you are ready to join a team of professionals dedicated to making a difference and making lives better, please apply today!
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