Medical Case Manager I
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Job Description
Medical Case Manager coordinating recovery, treatment plans, and care services for injured California workers. Providing remote case management with extensive local travel.
Responsibilities:
- Provide in-person and telephonic Medical Case Management
- Work closely with injured workers to facilitate recovery
- Collaborate with patients, families, physicians, healthcare providers, employers, referral sources, attorneys, advisors/clients, and coworkers
- Discuss current and alternate treatment plans with physicians using medical and nursing knowledge
- Assess, plan, implement, and evaluate patient progress
- Evaluate treatment plans for appropriateness, medical necessity, and cost effectiveness
- Attend doctors’, healthcare providers’, home, and attorney visits
- Attend hospital and long-term facility discharge planning conferences
- Conduct home visits for initial evaluations
- Develop long-term care strategies
- Negotiate delivery of durable medical equipment and nursing services
- Manage a caseload of workers’ compensation injured workers within a defined jurisdiction
- Travel locally up to approximately 60% of the work week/month
- Complete occasional overnight travel
- Comply with safety rules and regulations under the Injury and Illness Prevention Program
- Perform additional duties as required
Requirements:
- Registered nurse (RN)
- Graduate of an accredited school of nursing
- Current RN licensure in state of operation
- Experience as an RN Medical Case Manager is ideal, or clinical background in orthopedics, neurology, or rehabilitation preferred
- Certification as a CCM, CIRS, or other Case Management certification preferred
- Valid driver’s license
- Reliable transportation
- Ability to travel to assigned locations
- Effective communication and multitasking skills in a high-volume, fast-paced, team-oriented environment
- Strong interpersonal, time management, and organizational skills
- Computer proficiency and technical aptitude, including Microsoft Office and Excel spreadsheets
- Ability to work independently and within a team environment
- Cost containment background, such as utilization review or managed care, helpful
Benefits:
- Medical (HDHP) with Pharmacy
- Dental insurance
- Vision insurance
- Long Term Disability
- Health Savings Account
- Flexible Spending Account options
- Life Insurance
- Accident Insurance
- Critical Illness Insurance
- Pre-paid Legal Insurance
- Parking and Transit FSA accounts
- 401K
- ROTH 401K
- Paid time off
- Bonus eligibility
- State-of-the-art technological devices
- Career advancement opportunities
- Supportive culture
- Work from home
- Monday–Friday, regular business hours
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