Cardiac Telephonic Nurse Case Manager

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🔥 5 minutes ago

🏈 Alabama – Remote

🏈 Alabama – Remote

💵 $80k - $85k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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MDD Forensic Accountants

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1933

💸 Finance

Finance • Insurance • Consulting

MDD Forensic Accountants is a forensic accounting firm specializing in business valuations, shareholder disputes, and economic damage quantification. With over 40 offices globally, MDD provides expertise across a wide range of industries, delivering services to insurance companies, law firms, governments, and individuals. Their services include business interruption, lost profits, fraud investigations, and more, making them a trusted advisor for sound financial decision-making.

📋 Description

• Utilize advanced cardiac clinical knowledge to review, evaluate, and coordinate treatment plans involving cardiovascular conditions, cardiac procedures, and related medical care. • Monitor recovery progress and treatment outcomes for injured workers with cardiac injuries, diagnoses, or comorbidities. • Collaborate with treating physicians, cardiologists, healthcare providers, employers, adjusters, and injured workers to support optimal medical and return-to-work outcomes. • Evaluate medical necessity and appropriateness of cardiac treatment plans utilizing evidence-based treatment guidelines and clinical best practices. • Identify barriers to recovery specific to cardiac conditions and develop appropriate intervention strategies. • Educate injured workers regarding cardiac diagnoses, treatment recommendations, medication compliance, lifestyle modifications, and recovery expectations as appropriate. • Review medical records, treatment plans, diagnostic testing, and provider recommendations. • Encourage injured worker participation in treatment and recovery plans. • Evaluate return-to-work capabilities and discuss restrictions with providers and employers. • Obtain and review job descriptions to assist providers in determining appropriate work capacity. • Coordinate modified duty and transitional return-to-work opportunities when medically appropriate. • Adhere to state treatment guidelines, evidence-based protocols, account requirements, and organizational standards. • Monitor compliance with ODG, ACOEM, state-specific treatment guidelines, and utilization criteria as applicable. • Identify cases requiring utilization review, physician review, pre-certification, pre-authorization, concurrent review, or retrospective review. • Track treatment outcomes, disability durations, and return-to-work progress. • Maintain timely, accurate, and thorough case documentation within electronic case management systems. • Ensure compliance with HIPAA and all applicable state and federal privacy regulations. • Serve as a patient advocate while maintaining legal, ethical, and regulatory standards. • Participate in quality improvement initiatives, client meetings, and team collaboration activities as needed. • Assist with training, mentoring, and knowledge-sharing opportunities when appropriate. • Perform additional duties and special projects as assigned.

🎯 Requirements

• Active Registered Nurse (RN) license with proof of current state licensure. • Minimum of 3 years of clinical nursing experience. • Minimum of 3 years of Workers' Compensation case management experience preferred. • Recent cardiac clinical experience is required. • Cardiac experience may include one or more of the following: • - Working on a Cardiac Unit or Cardiac Step-Down Unit. • - Critical Care/ICU experience managing cardiac patients. • - Experience titrating cardiac drips and monitoring complex cardiac conditions. • - Employment within a Cardiology Practice or Cardiology Provider Office. • - Interventional Radiology experience supporting cardiac procedures. • - Cardiac Catheterization Lab experience. • - Cardiovascular Case Management experience. • - Other direct cardiac care experience involving the treatment and management of cardiac patients. • Strong understanding of cardiac conditions, treatment protocols, procedures, medications, diagnostics, and recovery planning. • Ability to independently review and interpret medical records, treatment plans, diagnostic studies, and physician recommendations. • Strong clinical assessment, care coordination, and communication skills. • Ability to work independently in a telephonic case management environment.

🏖️ Benefits

• Medical, dental, and vision plans to support your health and that of your family • A 401(k) plan with employer matching • Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees • Paid holidays • Life insurance and short-term and long-term disability coverage • Paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements