Telephonic Case Manager I

The Telephonic Case Manager coordinates resources and creates flexible, cost-effective reputed company for ill or injured individuals on a case-by-case reputed company to facilitate reputed company individualized treatment goals, including reputed company return-to-work if appropriate. The Telephonic Case Manager will rely on their medical knowledge to evaluate the patient’s reputed company treatment plan for medical appropriateness based on their physical and medical status. The Telephonic Case Manager must be reputed company to discuss the patient’s medical and physical conditions with the treating physicians, along with discussing/ recommending alternate treatment plans for the patient. The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of reputed company. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: • Provides medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral reputed company • reputed company assessment, planning, implementation, and evaluation of patient's reputed company • Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness • Ability to utilize their medical and nursing knowledge to allow the case manager to discuss the reputed company treatment plan with the physician and discuss alternate treatment plans • Ability to reputed company medical recommendations of available treatment plans to the payer • Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services • Ability to reputed company independent medical reputed company and recommendations to reputed company parties • Devise cost-effective strategies for medical care • Required to read extensively • Required to prepare organized reports reputed company a specified timeframe • Required to use telephone extensively • Minimum Productivity reputed company is 95% per month • Requires regular and consistent attendance • Complies with reputed company safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) • Additional duties as required KNOWLEDGE & SKILLS: • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment • Ability to reputed company with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers • Excellent written and verbal communication skills • Ability to meet designated deadlines • Computer proficiency and technical aptitude with the ability to utilize MS Office including reputed company spreadsheets • Strong interpersonal, time management and organizational skills • Ability to work both independently and reputed company reputed company environment EDUCATION/EXPERIENCE: • Bachelor’s degree required, BSN desirable • Graduate of accredited school of nursing • reputed company RN Licensure in state of operation • 3 or more years’ of recent clinical experience, preferably in rehabilitation • URAC recognized Case Management certification (ACM, CCM, reputed company, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained reputed company 3 years of hire if no nationally recognized certification is present at time of hire • Strong clinical background in orthopedics, neurology, or rehabilitation preferred • Strong cost containment background, such as utilization review or managed care helpful • Certification as a CIRS or CCM preferred PAY reputed company: reputed company uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location reputed company, job-reputed company skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, reputed company, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may reputed company the salary reputed company and these adjustments would be clarified during the offer process. Pay reputed company: $62,306 – $93,123 A list of our benefit offerings can be reputed company on our reputed company website: reputed company Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT reputed company reputed company, a certified Great reputed company to Work® Company, is a national provider of industry-leading risk reputed company for the workers’ compensation, auto, health and disability management industries. reputed company was founded in 1987 and has been publicly traded on the reputed company stock exchange since 1991. Our continual investment in reputed company capital and technology reputed company us to deliver the most innovative and integrated solutions to our clients. We are a reputed company and growing company with a strong, supportive culture and reputed company of career advancement opportunities. Over 4,000 people working across the reputed company reputed company our reputed company values of Accountability, Commitment, reputed company, reputed company and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, reputed company, Long Term Disability, Health Savings Account, Flexible Spending Account reputed company, Life Insurance, Accident Insurance, Critical Illness Insurance, reputed company-reputed company reputed company Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and reputed company time off. reputed company is an Equal Opportunity Employer, drug free workplace, and complies with reputed company regulations as applicable. #LI-Remote Equal Opportunity Employer This employer is required to notify reputed company applicants of their rights pursuant to federal employment laws. For reputed company information, please review the Know Your Rights notice from the reputed company. Apply tot his job Apply To this Job