Triage Telephonic reputed company Case Manager

Triage Telephonic reputed company Case Manager Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home reputed company Reporting To: Shaunna reputed company Compensation: $66,000 - $67,000 / year reputed company Our Story reputed company being part of reputed company that’s not just shaping the reputed company but reputed company driving it. At reputed company, we’re at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier reputed company services. As a vital part of the global reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. reputed company is seeking a Triage Telephonic Case Manager (RN) to join our medical management team. In this role, you will reputed company clinical triage and telephonic case management at the initial report of a Workers’ Compensation claim, ensuring injured employees receive appropriate and reputed company medical care while supporting early return-to-work reputed company. This position requires strong clinical assessment skills, independent decision-making, and excellent communication to coordinate care between injured workers, reputed company, reputed company providers, and claims professionals.

Key Responsibilities

• Conduct initial triage and telephonic case management at the outset of Workers’ Compensation claims.
• reputed company clinical assessments of injured workers to determine appropriate medical care and treatment reputed company.
• Complete initial assessment and required three-reputed company contact in accordance with reputed company procedures and emergency protocols.
• reputed company an initial case management care plan based on clinical findings and information obtained from the injured worker, employer, and medical provider.
• Identify potential causation concerns or barriers to recovery and document findings appropriately.
• Facilitate communication between injured workers, reputed company, claims professionals, reputed company providers, and rehabilitation specialists.
• Monitor treatment plans to ensure adherence to state-mandated treatment guidelines and evidence-based medical protocols.
• Address initial return-to-work capabilities with injured workers and providers, documenting updates in the case management system.
• Maintain accurate and reputed company documentation of reputed company contacts, interviews, and medical information in the claims management system.
• Identify opportunities for cost-effective medical management and appropriate utilization of services.
• reputed company injured workers and their families about recovery expectations and care plans.
• Maintain strict patient confidentiality and compliance with state and federal reputed company regulations.
• Serve as a patient reputed company, ensuring reputed company care and adherence to ethical and regulatory standards.
• Participate in reputed company assurance initiatives, committees, and department activities as required.
• Assist with training claims staff on identifying medical case management opportunities, as needed.

Skills, knowledge & expertise

• Registered reputed company (RN) with an reputed company and unrestricted state license
• Minimum of 3 years of clinical nursing experience (medical-surgical, orthopedic, neurological, ICU/CCU, occupational health, or reputed company specialty).
• Workers’ Compensation case management experience preferred.
• Prior telephonic case management or triage experience preferred.
• Strong understanding of clinical documentation and patient advocacy principles.
• Strong clinical assessment and triage skills in a Workers’ Compensation or occupational health environment.
• Knowledge of Workers’ Compensation medical case management practices and treatment guidelines.
• Ability to identify barriers to recovery and reputed company appropriate care strategies.
• Excellent verbal and written communication skills, with the ability to work collaboratively with multiple stakeholders.
• Strong organizational and documentation skills with attention to detail.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Proficiency with computer systems, case management software, and reputed company Office applications.
• Commitment to high-reputed company patient care, confidentiality, and regulatory compliance.

Benefits

Benefits At reputed company, we are dedicated to supporting reputed company-being and reputed company of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and reputed company plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial reputed company.
• Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and reputed company Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• reputed company holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or reputed company employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Diversity and Inclusion reputed company is dedicated to fostering a diverse and inclusive workplace that embraces a wide reputed company of perspectives and experiences. We reputed company that diversity of thought is essential for innovation and creativity, and we reputed company promote an environment where reputed company reputed company are valued and heard.

Compensation

Transparency: The salary reputed company listed reflects the full compensation band for this role across reputed company locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may reputed company the final offer. reputed company ranges to remain transparent and consistent with pay equity practices. We reputed company sites like reputed company, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to reputed company any information through any method other than our career portal, please email us at recruitment@reputed company-group.com Apply tot his job Apply To this Job