Nurse Case Manager

Job Description

Job Description

This is a remote position.

Aquarius Strategies has been retained to recruit Nurse Case Managers to provide case management services to patients receiving care under the Workers Compensation & Disability Insurance Claims Industry. This trusted organization is seeking case managers to service the following states/regions:

SouthEast PA,

Northern VA, &

NJ

Under general direction, the Nurse Case Manager is responsible for collaborating with all case-involved parties to assess, promote, and coordinate appropriate and timely client medical care. Expertise is utilized to implement interventions resulting in optimal recovery and functioning.

Essential Duties and Responsibilities:

• Support day-to-day operations of the Quality Management Program
  
• Initiate contact with Attorney, and maintain as necessary
  
• Secure Authorization for Release of Medical Information from consumer
  
• Conduct initial interview, collecting current and historical consumer information
  
• Obtain medical restrictions from attending physician through completion of Physical Capabilities Evaluation Form
  
• Coordinate receipt of all pertinent details necessary for assessment of medical condition
  
• Determine case direction, establishing specific rehabilitation objectives and goals towards physical and psychological recovery and define associated actions
  
• Coordinate service delivery from external providers and community resources
  
• Conduct cost analysis and negotiate fees
  
• Implement medical management through routine physician contact and routine contact with other relative medical personnel to include physical therapist, occupational therapist, nutritionist, and the like
  
• Coordinate and monitor participation in appropriate rehabilitative programs
  
• Monitor and evaluate rehabilitative progress and obtainment of goal
  
• Secure completed Job Description from the consumer’s Employer, and pursue job accommodations as appropriate
  
• Coordinate and maintain schedule of daily activities
  
• Formulate timely case reports, to include presentation and analysis of factual information
  
• Submit timely office reports as requested
  
• Determine vocational interventions and maintain regular contact with Vocational Case Manager when appropriate to monitor Consumer progress
  
• Potentially travel routinely within two-hour, one-way driving radius for client and/or medical appointments; occasional extensive travel also required
  
• Participate in continued training in services and industry
  
• Will refrain from assigning any clinical duties to non-clinical, administrative support staff
  
• Will practice only within the boundaries of competence, based upon education, training, certification and professional experience
  
• Will adhere to all applicable physician, hospital, facility procedures, to include checking in with designated personnel
  
• Perform other duties and responsibilities as assigned
  

Competencies:

• Ability to establish professional working relationships and effective communication with employees, clients, vendors industry partners
  
• Ability to maintain daily scheduled activities with effective time management skills
  
• Ability to conduct thorough medical records review
  
• Ability to assess medical status and formulate recommendations
  
• Ability to coordinate medical services
  
• Ability to write factual, clear and concise reports, to include situational analysis
  
• Informed, effective and efficient decision-making skills
  
• Computer skills, to include proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
  
• Organization and accuracy skills
  
• Ability to communicate clearly, both verbally and in writing
  

Education and/or Experience: ( includes certificate & licenses )

• Associate’s Degree in Nursing; Bachelor’s Degree preferred
  
• Minimum 5 years of direct patient care experience required
  
• Previous case management experience desirable
  
• Current, unrestricted licensure as a Registered Nurse, permitting practice in a state or territory of the United States; specifically, those states or territories in which services are provided
  
• Maintain at least one current, unrestricted industry-related National Professional Certification (achieved or working towards upon eligibility)
  
• Participate in ongoing continuing education courses/activities as required by the standards of current professional license(s)/certification(s)
  
• Possess independent transportation and current, unrestricted driver’s license
  

Healthcare
Dental
Vision
Life, Accident & Disability Benefits
Spending Accounts

Health & Wellness Programs

Supplemental Health Benefits

401k Retirement Plan (matching)