Work from Home Telephonic Nurse Case Manager – Hiring in all States

YouCase Management is a collaborative process to promote quality cost effective outcomes, which enhance the physical, psycho-social, and vocational health of individuals. This includes assessing, planning, implementing, coordinating, and evaluation of service options. The goal of the Case Manager is to assist the injured worker in receiving appropriate, cost effective medical care for their injury in a timely manner, and to expedite their return to work.

What you’ll do:

  • Once a file is identified as needing a Telephonic Case Manager, the TCM ensures telephonic case management activities are processed in accordance with EK’s standard. Activities may include:
  • Completing referrals within computer database from either injury report or information gathered from the web-based system
  • Performs 3-point contact on new files and, depending on account, forwards within 24 or 72 hours from date of referral
  • Reviewing and evaluating all medical correspondence and provider reports obtained to determine work status of IWs or patients
  • Reviewing treatment plan history and direction of file with client, when necessary
  • Providing a 24-hour update after all significant activity
  • Evaluating clinical status of claimant and researches for alternative options to treatment as warranted
  • Communicating with the claim’s examiners regarding directives, and provides updates on file status
  • Arranging transportation services when necessary and authorized
  • Evaluating therapy facilities and their progress on specific cases
  • Preparing comprehensive notes following any discussions had with IW, medical providers, claims examiners, and employers in the case file in EK TCM Ahshay and client system, per policy standards and procedure
  • Completes initial reports every 14 days and every 30 days thereafter, according to account profile and service type.  
  • Utilizes the nursing process in conjunction with URAC standards, EK Standards and client guidelines to manage and move files forward. 

What you should have:

  • Graduate of an accredited school of nursing
  • Mandatory valid state-appropriate RN license in good standing with no restrictions (may be required to obtain additional state RN licenses) CA License preferred, but not required
  • Possesses and can demonstrate the professional and technical skills needed
  • Experience in Field or Telephonic Case Management, Workers’ Compensation or Liability experience highly preferred, but not required
  • Experience in Home Health Care, Occupational Health considered a plus
  • Certified Case Manager (CCM), Certified Occupational Health Nurse (COHN or COHN-S) or Certified Rehabilitation Registered Nurse (CRRN) highly preferred, but not required. 
  • High comfort level with computers and computer programs (MS Word, MS Excel, Email)
  • Excellent Written and Oral Communication Skills
  • Excellent Interpersonal Skills
  • Strong Organization Skills
  • High comfort level with computers and computer programs (MS Word, MS Excel, Email)
  • Ability to work independently with minimal supervision
  • Ability to meet deadlines in a high pressure, time sensitive environment 
  • Ability to lift up to 20 lbs

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