Field Nurse Case Manager

🕒 Maio 19

🏖️ New Jersey – Remoto

🏖️ New Jersey – Remote

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

👔 Gerente

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Opus Medical

SiteLinkedInTodas as Vagas

201 - 500 funcionários

⚕️ Seguro de Saúde

🤝 B2B

Healthcare Insurance • B2B

A Opus Medical é uma empresa de gestão de casos médicos liderada por médicos, que oferece uma abordagem de concierge atenciosa para a recuperação de lesões no trabalho para empregadores, pagadores e trabalhadores lesionados. A empresa fornece supervisão médica, gestão de casos no campo e por telefone, revisão de registros por enfermeiros, avaliações médicas iniciais, planejamento de cuidados de vida, suporte de rede (incluindo IME e revisão por pares), além de serviços adicionais como projeção de custos médicos e reservas para o Medicare. A Opus enfatiza o cuidado baseado em evidências, retorno ao trabalho mais rápido, custos totais de sinistros mais baixos e melhora na satisfação dos trabalhadores através de coordenação clínica personalizada e um sistema habilitado por tecnologia chamado Maestro.

Descrição

• Nurse liaison who coordinates care and communicates pertinent medical information among the Injured Worker, the Insured, and the Carrier to facilitate appropriate treatment, successful rehabilitation, and return to work. • Follow all policies/procedures in the Case Management (CM) plan; retain accountability for the CM process. • Accept referrals as assigned by the Director of Case Management. • Make initial contacts per CM plan; schedule initial assessment; obtain date of next physician appointment. • Confirm assignment with referral source; clarify special handling instructions. • Build professional relationships with clients; treat claimants with dignity. • After physician appointments, contact Carrier and Insured per protocol; maintain ongoing communication with Injured Worker, Insured, and Carrier. • Record data and billing in CaseAnyplace; submit timely monthly reports (Preliminary, Initial, Progress, Closing). • Attend physician appointments; obtain diagnosis, prognosis, treatment plan, rehab length, estimated RTW (modified/regular duty), and MMI/Full Recovery as appropriate. • Refer to Vocational Counselor for job analyses (modified/regular duty) when appropriate and approved by Carrier. • Recommend IME physicians; coordinate and attend IMEs. • Coordinate transportation as needed. • Provide translation as needed (for bilingual nurses). • Monitor treatment plan; attend therapy sessions when appropriate; maintain contact with therapists for updates. • Request transfer of files to Vocational Counselor when appropriate (LMS, Voc Rehab). • Assist Carrier/Insured with RTW planning (modified or regular duty). • Provide information to Defense Attorneys as appropriate. • Promote teamwork with all staff members. • Maximize accurate, appropriate billable hours per monthly target (8 hrs/day). • Maintain licensure/certifications; complete required annual training on time. • Perform additional professional duties as assigned. • Retain responsibility for tasks delegated to non-clinical staff.

🎯 Requisitos

• Registered Nurse: Current, unrestricted state license; licensed in each state where field case management is provided; able to perform independent assessments within scope. • Discipline Eligibility: Practices in a U.S. state/territory allowing independent assessment within scope of practice. • Education: Completion of a nursing program and ongoing CE as required. • Certification: One or more national certifications within 4 years of hire (e.g., CCM, CRC, CLNC, CRRN) preferred. • Experience: Two years FTE direct case management for injured workers or two years under supervision preferred.

🏖️ Benefícios

• Competitive pay and bonus program • Health, dental, vision, and retirement plans • Flexible scheduling • Nurse referral program • Continuing education support