Through the use of clinical tools, telephonic interviews, and clinical information/data, completes assessments that will take into account information from various sources to address all conditions including biopsychosocial, co-morbid and multiple diagnoses that impact recovery and return to work.
Leverages critical thinking, extensive clinical knowledge, experience, and skills in a collaborative process to develop a comprehensive strategy for the injured worker to become medically stable and/or return to work.
Independently identifies complex situations where communication with internal and/or external partners is needed to reach a full understanding of the factors involved with the assessment of the mechanism of injury, causality, and ability to return to work.
Application, Interpretation and Compliance with clinical criteria and guidelines, applicable policies and procedures, regulatory standards, and jurisdictional guidelines to determine eligibility and integration with available internal/external resources and programs.
Using holistic approach to focus on medical and ability management activities resulting in accurate and timely treatment and return to work.
Consults with supervisor and others to address and problem solve barriers to meeting goals and objectives, participate in roundtables and claim meetings with claim partners to focus and benefit overall claim management.

RN with current unrestricted state licensure required.
Associate degree in Nursing required.
3 years clinical practice experience required.
Bachelor’s degree in nursing preferred, but not required.
Certification as a CCM (CDMS, CRC, CVE and/or current CRRN), or willingness to pursue.
Workers Compensation case management experience preferred.
Basic Computer proficiency (Microsoft Office Products including Word, Outlook, Excel, Power Point) which includes navigating multiple systems.
Ability to effectively communicate telephonically and in written form.
Ability to synthesize large volumes of medical records & facilitate multi-point care coordination.
Must meet productivity & quality expectations.
Ability to organize and prioritize daily work independently and effectively.

Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition.

Nurse Case Manager

Key skills