Job Description
Job Title Telephonic RN Case Manager
Requirement ID 655411
Begin Date 10/30/12
Duration 3-6 Months/Contract-to-Hire
Location Lake Mary,  FL 32746-2109
Other Location Ft. Lauderdale, FL
Description

·       Provide telephonic case management of Workers’ Compensation claims by facilitating and coordinating all aspects of the injured worker’s medical care in a timely manner and with consideration to the criteria based model

·       Maintain high standard of file documentation to ensure attention to detail and file accuracy

·       Interact with strategic partners to obtain or clarify clinical information

·       Compares clinical information against the appropriate criteria set

·       Authorize medical care and practice medical costs containment skills

·       Provide medical authorization in a timely manner

·       Based on rotation schedule, handle after hours calls received from on-call phone

·       Work collaboratively with team adjuster and assistant to ensure continuity of care

·       Assist in the development of internal procedures and training concerning medical case management

·       Assist with ad hoc projects as assigned

·       Moderate to heavy keying is required

·       Bachelor’s degree or equivalent work experience.

·       Current Florida RN license to include 3 plus years in nursing and 2 years direct related experience in case management.

·       CCM or CRRN with QRP (if does not have, will obtain within 1 year).

·       Must possess intermediate PC skills in windows based environment (Word/Excel) and claims management system.
Occasional travel to include site or patient visits.

 

     **Worker's Comp Case Management experience OR Emergency Room, orthopedics, cardiology or neurology experience required.

Preferred Skills:

 

·    Utilization management/cost containment experience.


 

Required Skills •Bachelor’s degree or equivalent work experience.
•Current Florida RN license to include 3 plus years in nursing and 2 years direct related experience in case management.
•CCM or CRRN with QRP (if does not have, will obtain within 1 year).
•Must possess intermediate PC skills in windows based environment (Word/Excel) and claims management system.
Occasional travel to include site or patient visits.
*Worker's Comp Case Management experience OR Emergency Room, orthopedics, cardiology or neurology experience required.
 
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