Nurse Case Manager

Spooner Medical Administrators, Incorporated (SMAI) is a family owned and operated company that offers rewarding career opportunities for motivated individuals who are passionate about excellence and growth. Since 1997, SMAI’s proactive philosophy and best practices have set the standard in workers’ compensation by continuously improving the delivery of case management, utilization review and billing services to help facilitate a successful return to work for the injured worker.

The Case Manager is primarily responsible for coordinating and facilitating medical and rehabilitation services to assist injured workers in obtaining their pre‑injury status, maximum medical improvement and/or return to work.

Essential Functions

• Initiate telephonic contact with the injured worker, physician of record and employer to perform an assessment and obtain information regarding the work injury and return to work options.
• Develop a written case management plan that addresses the injured workers’ needs, short and long term goals and any psychological issues that may arise as a result of the injury.
• Monitor the case management plan and coordinate any additional resources to further the plan’s success including referrals to vocational rehabilitation when applicable.
• Work in conjunction with the Utilization Review department to coordinate services where appropriate and make determinations regarding the need for alternative treatment or services necessary to move the case towards a return to work.
• Use critical thinking skills and problem solving techniques throughout the case management process and provide assistance to injured workers’ with disabilities or barriers.
• Serve as an advocate for the injured worker while coordinating services with the employer, provider and any additional parties to the claim.
• Participate in some On‑Site Case Management activities to address the injured workers’ needs.
• Participate in continuous improvement activities and other assigned duties as assigned.

Supervision Received

Reports to the Case Management Supervisor.

Experience and Education Required

• Current, unrestricted Ohio RN licensure or one of the following case management certifications: CCM, CDMS, CRC, RN C, RN BC, CRRN, COHN.
• Minimum of 2 years post‑graduate experience in direct patient care.
• General working knowledge of the medical/vocational case management process including medical terminology, clinical pharmacology and acute/chronic disability or illness.
• Ability to establish a working relationship with medical providers and employers.
• Ability to travel for work.

Additional Skills Needed

• Effective written and verbal communication.
• Strong organizational ability.
• Basic computer literacy skills.

The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job. While performing the duties of this job, the employee typically works in a normal office environment. The noise level in the work environment is usually quiet.

Invitation for Job Applicants to Self‑Identify as a U.S. Veteran

• A “disabled veteran” is one of the following:
  • a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
  • a person who was discharged or released from active duty because of a service‑connected disability.
• A “recently separated veteran” means any veteran during the three‑year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
• An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
• An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Voluntary Self‑Identification of Disability

• Disabilities include, but are not limited to:
• Alcohol or other substance use disorder (not currently using drugs illegally)
• Blind or low vision
• Cancer (past or present)
• Cardiovascular or heart disease
• Celiac disease
• Cerebral palsy
• Deaf or serious difficulty hearing
• Diabetes
• Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
• Epilepsy or other seizure disorder
• Gastrointestinal disorders, for example, Crohn’s Disease, irritable bowel syndrome
• Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
• Missing limbs or partially missing limbs
• Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
• Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
• Neurodivergence, for example, attention‑deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
• Partial or complete paralysis (any cause)
• Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema