As a Telephonic Nurse Case Manager, you will work with a dynamic team to assess disability claims, involving frequent interactions with claims team members, consulting physicians, attending physicians, and our customers. Primary functions include reviewing and assessing medical documentation/information, participating in return-to-work efforts and working with case managers on the clinical aspect of the claims process. You will strategize with claim professionals to assess and manage medical and disability exposure and return to work opportunities. This position is office based and you will be asked to work out of our GENEX Cincinnati, OH location.
•*SIGN ON BONUS AVAILABLE!**
Main responsibilities will include but are not limited to:
• Responsible for assessment, planning, coordination, implementation and evaluation of disabled individuals involved in the medical case management process.
• Working as an intermediary between employer, employees and medical care providers, you will closely monitor the progress of the disabled employee.
• Work diligently at facilitating appropriate and timely return to work at an optimal level of work and functioning in partnership with the employer.
• Effectively manage assigned caseload of medical/disability cases within company and regulatory guidelines.
•Degree from an accredited nursing school required, Bachelor of Science in Nursing preferred.
•2+ Years clinical nurse experience with a preference for previous insurance nurse case management, orthopedic, emergency room, critical care, home care or rehab care experience.
•Case Management of STD/LTD experience required
•Current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law.
•Preferably holds one of the following certifications: CCM, CDMS, CRRN, or COHN
•Strong communication skills in order to effectively communicate with claimants, medical professionals, employers, claims staff and others.
•Good negotiation skills to effectively establish target return to work dates.
•Bilingual is a plus.
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