Telephonic Nurse Case Manager at Boston

Job Description

The Telephonic Case Manager performs initial and on-going clinical assessment and evaluation needed for treatment of work related injury and illness for a dedicated client. The Telephonic Case Manager coordinates resources with on-going monitoring and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return to work if appropriate.Essential Job Duties:Provide and maintain medical case management to the injured worker through coordination with the patient, physician, employer, other health care providers, and the referral source. *Utilizes national treatment guidelines to support clinical decision making. *Provide assessment, planning, implementation, and evaluation of patients progress. * Works well in team environment, and educates non-clinical staff when opportunity presents. * Required to read extensively. * Required to prepare organized reports within a specified timeframe. * Required to use telephone extensively. * Evaluate patients treatment plan for appropriateness, medical necessity, and cost effectiveness. *Performs the six essential activities of case management: Assessment, planning, implementation, coordination, monitoring and evaluation of work related injuries and illnesses. * Follows established policies and procedures.

Job Requirements

Graduate of an accredited school of nursing with an Associates Degree (or higher). Current State of Massachusetts RN licensure unrestricted. Two years of full-time direct clinical care to the consumer preferably in rehabilitation, orthopedics, critical care or neurology/neurosurgery. Previous experience involving judgment and decision making in a utilization or case management positions for two (2) years required. Maintains one current URAC approved certifications as a case manager: o CCM, Certified Case Manager o CDMS, Certified Disability Management Specialist o CMAC, Case Management Administrator, Certified o CMC, Case Management Certified o CRC, Certified Rehabilitation Counselor o CRRN, Certified Registered Rehabilitation Nurse o COHN, Certified Occupational Health Nurse o RN,C Registered Nurse Case Manager o RN,BC Registered Nurse Case Manager PREFERRED EDUCATION Strong cost containment background, such as utilization review or managed care required. Massachusetts workers compensation case management experience required. BSN preferred.
Country: USA, State: Massachusetts, City: Boston, Company: CorVel Corporation.