Registered Nurse Case Manager (specializing in Workers Compensation)

DescriptionPRIMARY PURPOSE: To perform initial evaluation assessments and evaluate need for alternative treatment; to negotiate claims with providers and employers; and to provide case direction and supervision to field case specialists when on-site intervention is required ensuring quality and appropriate service delivery.ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:Performs initial evaluation assessment via telephone calls to client, employer, and physician. Evaluates need for alternative treatment. Negotiates level of care, intensity and disability duration with providers Negotiates and coordinates a prompt return to work with employer Maintains accurate record of management including costs, savings and demographic data Adheres to quality assurance standards Provides case direction and supervision to field case specialists when on-site intervention is required; ensures quality and appropriate service delivery Communicates effectively with handling claims examiner, client, claimant, and supervisor Supports the Total Performance Management initiative Requirements Baccalaureate degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred Active RN license required Certification in rehabilitation nursing or a related specialty is highly preferred Valid driver's license required Two (2) years of clinical experience required Knowledge of workers compensation laws and regulations Familiarity With ACOEM and/or Interqual guidelines.