Essential Duties & Responsibilities

• Assesses disability status makes recommendations and identifies appropriate resources.
  
• Gathers and coordinates medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and addresses length of disability.
  
• Consults on case management issues in area of specialty and applies effective case management interventions.
  
• Works with medical and other providers to ensure appropriate treatment and return to work.
  
• Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements.
  
• Addresses causality and refers to appropriate medical expertise.
  
• Documents according to jurisdictional, departmental and accreditation requirements.
  

Skills, Knowledge & Abilities

• Strong knowledge of case management, specialty area, medical terminology and conditions, insurance industry as well as company policies and procedures.
  
• Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service.
  
• Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise and effective manner.
  
• Strong interpersonal skills with the ability to effectively interact with internal and external business partners.
  
• Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks.
  
• Knowledge of Microsoft Office Suite as well as other business related software.
  
• Ability to work independently.

Education & Experience Required

• Current unrestricted RN license required.
  
• Minimum 3 to 5 years diverse clinical background. Case management or disability management experience required. Workers Compensation experience strongly preferred.
  
• Bilingual candidates would be ideal.
  
• Certified Case Management (CCM) required or the ability the sit for the exam within 1st year of hire.
• Additional certifications would be preferred such as;
• Certified Disability Management Specialist (CDMS), Certified Occupational Health Nurse (COHN), or Certified Rehabilitation Nurse (CRN).