Medical Case Manager- CA
Core
Provide effective medical case management services for injured workers and disabled individuals to facilitate return-to-work (RTW) and case resolution.
Role type
Senior IC medical case manager (workers' compensation)
Builds
Medical case management services for injured workers/disabled individuals
Domain
Workers' compensation / Health insurance
Deliverable
client delivery
Required skills
Clinical nursing expertise, case management practices, data analysis, communication, organizational skills, problem-solving
Preferred skills
National case management certification (CCM, CRC, COHN, CRRN), BSN degree, workers' compensation experience
Technologies
Microsoft Office, Lotus Notes
Responsibilities
Review case records and analyze data to evaluate medical status and identify needs; Render opinions on case costs and treatment plans; Coordinate return-to-work with injured workers, employers, and physicians; Communicate with claims adjusters regarding case activity; Obtain medical records and facilitate peer reviews/IMEs; Travel to homes, healthcare providers, and job sites (~70% of time).