Job Description

RN Case Manager is responsible for pro-active medical case management of assigned injured worker (clients) to promote stewardship of healthcare dollars and create value for our customers with cost effective outcomes, including timely return to work as appropriate. This role provides no hands-on care, rather applies medical knowledge and critical thinking to the case management process to assess, evaluate, plan, implement, and proactively manage cost effective treatment for injured individuals. Discusses the patient's medical and physical conditions with treating physicians, along with discussing evidence-based guidelines for the patient. Must be able to build therapeutic nurse-patient rapport, explain medical conditions and treatment plans to the patient and family members, supporting compliance with treatment to achieve the purpose of referral and optimal outcomes. Requires focus on customer service, pro-active strategies, and communication of evidence-based guidelines to adjuster customers with nurse recommendations. Daily travel required within a 2-hour radius, with occasional overnight stays for company meetings and events.

Position Requirements:

3 or more years of recent clinical Registered Nurse experience. Experience in Case Management, Critical Care, Occupational Medicine, Orthopedics, or Home Health/Hospice is preferred.

Case Management Certification (CCM) desired - required to be obtained within 2 years of hire if no nationally recognized certification is present at time of hire.

Unrestricted active RN License in state of operation

Valid driver's license and good driving record, with proof of Active Auto Liability Insurance

Key Results Area #1: Demonstrates skillful use of the Case Management Process

a) Demonstrates and is accountable for the Case Management Standards of Practice, Company Policies and Procedures , Quality Assurance Guidelines, and Company goals.

b) Maintain effective communications with the multidisciplinary team to assure continuity of care with focus on the common goal of optimal recovery and return to work.

c) Identifies and demonstrates opportunities for CM interventions to solve problems and promote quality injury treatment.

d) Assure treatment and transitions of care are appropriate and timely

e) Implements care such as negotiation the delivery of durable medical equipment and nursing services. Devises cost-effective strategies for medical care.

f) Collaborates and documents treatment planning with stakeholders

g) Monitors client and treatment for interventions, barriers, and revises plan of care as appropriate

h) Evaluates outcomes, documenting impact on quality care, cost effectiveness of CM interventions

i) Utilize and document Evidence Based Guidelines to manage cases

Key Results Area #2: Delivers Customer Service to WOW both adjuster and employer

a) Meets QA guidelines on timeliness for service delivery points.

b) Demonstrates courteous, professional interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers

c) Reports and documentations show value and impact of CM interventions

d) Demonstrates customer trust and satisfaction evidenced by customer feedback.

Key Results Area #3: Serves and contributes to the Company processes and culture that deliver services to our customers.

a) Meets and maintains minimum billable standards with an average of 18-24 FCE cases per month

b) Excellent written and verbal communication skills.

c) Computer proficiency and technical aptitude with the ability to utilize MS Office.

d) Schedule work load for maximum efficiency and productivity

e) Responsive, dependable, punctual, and is a team player promoting team and company goals.

f) Consistently performs in the CM role while meeting and exceeding expectations

g) Takes ownership of their own professional growth in the role of CM

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Benefits:

Continuing education credits Dental insurance Disability insurance Flexible schedule Health insurance Life insurance Mileage reimbursement Paid time off Referral program Retirement plan Vision insurance
Application Question(s):

This is a work from home position. Can you provide a private office workspace at home?
Education:

Associate (Required)
Experience:

Registered Nurse: 3 years (Required)
License/Certification:

RN license in state of Arkansas (Required)
Willingness to travel:

50% (Required)
Work Location: Hybrid remote in Little Rock, AR 72211