Field Nurse Case Manager

🕒 il y a 23 jours

🏖️ New Jersey – Distant

🏖️ New Jersey – Remote

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

👔 Manager

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Opus Medical

Site WebLinkedInTous les Emplois

201 - 500 employés

⚕️ Assurance santé

🤝 B2B

Healthcare Insurance • B2B

Opus Medical est une entreprise de gestion de cas médicaux dirigée par des médecins qui offre une approche personnalisée et haut de gamme pour la récupération après blessure au travail, pour les employeurs, les payeurs et les travailleurs blessés. La société propose une supervision par des médecins, une gestion de cas sur le terrain et par téléphone, une révision des dossiers par des infirmiers, des évaluations médicales précoces, une planification de la vie, un soutien réseau (y compris les évaluations médicales indépendantes et les revues par les pairs), ainsi que des services à valeur ajoutée tels que les projections de coûts médicaux et les provisions pour Medicare. Opus met l'accent sur des soins basés sur les preuves, un retour au travail plus rapide, des coûts de réclamation totaux réduits et une satisfaction accrue des travailleurs grâce à une coordination clinique personnalisée et un système technologique appelé Maestro.

Description

• 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.

🎯 Exigences

• 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.

🏖️ Avantages

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