Sr Case Management Specialist - 90300793 - Wilmington

Sr Case Management Specialist - Wilmington

This role provides active management of Amtrak injured workers from the day of injury through their return to work at Amtrak. This role is the point of contact for the injured worker, the manager, and the medical management team(vendor) and to ensure any one returning to work has the appropriate medical evaluation and clearances or to refer inconsistencies to Sr Manager or Medical Director. This role identifies transitional duty for Amtrak injured workers so that they can return to productive paid employment as they recover from their on-duty-injuries and refers those who are not able to return to their positions to the ADA process. Coordinate with injured employees, their supervisors, occupational health care vendor and health care providers in identifying those jobs that can be modified to fit the employee's medical restrictions until they can return to work full duty.

Essential Functions:

• Performs case management for injured workers.
• Reviews all medical documentation to ensure the employee has been medically released to return to his or her position by the treating doctor without restrictions.
• Escalates any concerns about fitness for duty to the Corporate Medical Director.
• Once the Case Manager/SrCase Manager (CM/SCM) has the reviewed the release, they will send the request for the Return to Work(RTW) drug tests to the Return to Work coordinator.
• Works with the injured workers, the supervisor, the external medical management vendor and treating health care providers to identify when an injured employee may return to work and to facilitate transitional duty where appropriate.
• Ensures uniform implementation of Right Care Day 1 (RCD1) policies and processes and adherence to HR policies as it relates to leave and return to work.
• Identifies Transitional Duty assignments where appropriate: Uses clinical knowledge and/or experience to anticipate eligibility for transitional duty (e.g. return to usual position within 90 days). Uses knowledge of Amtrak positions to identify possible alternate work opportunities.
• Works with supervisors and labor organizations to develop transitional duty assignments within Amtrak, and where possible, with non-profit organizations, for employees who have physical restrictions but are expected to return to duty at their own position within 90 days.
• Track injured employees' attendance and recovery progress, overseeing their transition to modified duties or alternative work, and coordinating their return to full duty with relevant stakeholders.
• Ensures effective communication about injured worker status with appropriate parties: Provides anticipatory guidance to managers and Claim adjustor on duration of employee absence and return to work. Monitors the injured worker's progress towards maximum medical improvement and performance at transitional duty assignments and coordinated return to full duty with medical providers, supervisors, Amtrak Medical Services and the injured worker.
• If the injured worker is not able to participate in a transitional duty assignment, the SrCase Management Specialist (SCMS) ensures the employee has been released with no restrictions prior to returning to his or her position.
• Collaborate with the company's labor organizations to facilitate alternative work arrangements with nonprofit organizations and management for employees unable to perform modified duties.
• Deliver ongoing educational training sessions to management and staff to enhance comprehension and backing for the program's objectives.
• Customer Outreach: Conduct continuous educational training programs with management and their staff to ensure a complete understanding of and support for the program in the field. Assist managers/supervisors in identifying potential transitional duty assignments before the need arises through site visits and consultations. Cultivate partnerships and business affiliations with healthcare providers and nonprofit entities to achieve mutually advantageous outcomes for the program.
• Drives Process Improvements: Develops improvements in case management processes within Amtrak and with the medical management vendor to generate efficiencies, cost savings, and/or improvements in the care of the injured worker, i.e. auditing. Review the Provider Manual distributed to treating providers for updates. Participates in regular meetings with the medical management vendor. Represents RCD1 in process improvement activities with other Amtrak partners (e.g. Claims, System Safety, Leave Management examples). Evaluate and refine the transitional work program, ensuring its effectiveness and alignment with organizational goals.

Minimum Qualifications:

• Bachelor's degree or equivalent combination of training, deduction, and relevant experience may be considered in lieu of a degree
• 3 or more years of prior relevant experience
• Medical assistant, vocational rehabilitation counselor, claims adjustor, human resources or workforce planning
• Related occupational health experience, case management experience, experience with Workers Compensation/FELA or non-occupational disability programs.
• Ability to work with union representatives, supervisors/managers, and external agencies to identify transitional duty options for injured workers.
• Ability to build relationships with customers in the field.
• Familiarity with medical terminology and conditions
• Excellent written and verbal skills and ability to communicate professionally and effectively with all levels of management and agreement employees.

Preferred Qualifications:

• Previous experience in a medical case manager role
• Experience working with injured workers in a medical office or hospital or handling injured workers claims in an insurance environment.
• 5 or more years working with injured workers in a medical office or handling injured workers claims in an insurance environment.
• Occupational health experience, case management experience, experience with Workers Compensation/FELA or non-occupational disability programs
• Experience in Workers Compensation, FELA, or non-occupational disability management
• Certification in occupational health nursing (COHN), Case Management (CCM)

Knowledge, Skills, and Abilities:

• Demonstrate the ability to collaborate effectively with union representatives, managers, and vendors to address on-duty injuries.
• Exhibit excellent written and verbal communication skills to interact with individuals at all levels of management and within union organizations.
• Possess the capability to conceptualize, develop, and execute transitional work programs tailored to the unique requirements of injured employees and organizational objectives.
• Demonstrate adeptness in managing relationships with diverse stakeholders, including union representatives, managers, and external agencies associated with transitional work programs.

Salary/Hourly Range: $78,600.00 $101,844.00. Pay is based on several factors including but not limited to education, work experience, certifications, etc. Depending on an employee's assigned worksite or location, Amtrak may consider a geo-pay differential to be applied to the employee's base salary. Amtrak may offer additional incentive and pay programs to recognize and reward our employees, including a short-term incentive bonus based upon factors such as individual and company performance that is commensurate with the level of the position.

In addition to your salary, Amtrak offers a comprehensive benefit package that includes health, dental, and vision plans; health savings accounts; wellness programs; flexible spending accounts; 401K retirement plan with employer match; life insurance; short and long term disability insurance; paid time off; back-up care; adoption assistance; surrogacy assistance; reimbursement of education expenses; Public Service Loan Forgiveness eligibility; Railroad Retirement sickness and retirement benefits; and rail pass privileges.