Case Manager RN

• Medical case management with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment along with medical reviews as applicable to claim handling laws and regulations.
• Responsible for helping ensure disabled parties receive appropriate treatment directly related to the disability in question and assist claim handlers in managing medical treatment to an appropriate resolution.
• Use clinical/nursing skills to work with the physicians and therapists to set up medical assessments to develop an overall treatment plan that ensures cost containment while meeting state and other regulator's guidelines.
• Explain physician's and therapists' instructions, and answer any other questions the claimant may have in an effort to facilitate his/her return to work.
• Collaborate with employers on possible modifications to job duties based on medical limitations and the employee’s functional assessment.
• Maintain all case documents in files ensuring a comprehensive and detailed source of information for all parties involved in the case. As well as, document and report case activity for accurate case management and billing.
• Prepare detailed evaluation reports and maintain contact with all parties involved to monitor, update, and advance case activity to ensure the progress of the case.
• Maintain and acquire knowledge of developments in the medical case management field.
• Keep up-to-date of municipal, state and federal statutory requirements and local workers' compensation laws and regulations, as well as other issues related to the case management/managed care industry. The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.

• Associate or Bachelor’s Degree in nursing or in a health or human services related field
• Masters level and/or advanced study health-related field desired
• Background experience and knowledge in Short-Term Disability, FMLA, and worker’s compensation law and practices
• Prior case management experience preferred
• Excellent organizational skills and attention to detail.
• One year experience with disability/leave of absence claims preferred.
• Ability to manage confidential and sensitive employee information and adhere to strict data privacy standards.
• Comfortable working in a high-energy, quickly changing and demanding environment
• Excellent verbal and written communication skills.
• Strong attention to detail and organizational skills.

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

• Associate or Bachelor’s Degree in nursing or in a health or human services related field
• Masters level and/or advanced study health-related field desired
• Background experience and knowledge in Short-Term Disability, FMLA, and worker’s compensation law and practices
• Prior case management experience preferred
• Excellent organizational skills and attention to detail.
• One year experience with disability/leave of absence claims preferred.
• Ability to manage confidential and sensitive employee information and adhere to strict data privacy standards.
• Comfortable working in a high-energy, quickly changing and demanding environment
• Excellent verbal and written communication skills.
• Strong attention to detail and organizational skills.