Telephonic Case Manager

Job Description

Job Description

Telephonic Case Manager - RN (remote, professional/business, non-clinical, must reside in Atlanta or surrounding areas)

Feel the Value of Excellence by providing quality medical case management for injured workers, coordinating appropriate care, making recommendations, and professionally communicating with insurance carriers, healthcare providers, ancillary vendors, employers, and attorneys. Make a difference by driving to and attending medical appointments in-person. Complete prompt and thorough documentation and qualify for bonus compensation. Enjoy inserting your own style into the work you do and benefiting from more flexibility at work. This position offers the privilege to impact your earnings and the opportunity to adjust your schedule. Do you have a strong work ethic and high integrity? Then this very rewarding and autonomous role might just be the right fit!

COMPENSATION RANGE: $88,000.00 to $140,000.00 annually

GENERAL SUMMARY:

Provide telephonic case management services (within the worker’s compensation industry) by utilizing professional judgment and discretion, applying professional processes, and by using professional expertise to guide complex decision making in alignment with ISYS, customer, and Case Management Society of America (CMSA) expectations.

Facilitate appropriate qualitative and timely medical care for injured workers by implementing prudent case management strategies, making appropriate recommendations to advance case progression, demonstrating proactive communication, and appropriate coordination with all parties to enable optimal recovery outcomes, including return to work determination, file progression towards Permanent and Stationary designation, and cost containment for the customer.

Facilitate timely claim resolution through proactive and professional communications, conducting case specific research, information analysis and providing appropriate advice, direction, and action plans to implement treatment and optimize realistic outcomes. This position differs from Case Manager, as primary case management duties are carried out telephonically with minimal field-based case management activity.

ESSENTIAL JOB FUNCTIONS:

• Telephonic management of cases as assigned by ISYS, including “rush”/same day referrals from ISYS’ customers and attendance at medical appointments scheduled during the hours of the facilities providing treatment.

• Autonomous management of assigned caseload, including coordination of weekly and daily work activities and schedule, ensuring optimal time management and professional prioritization of all activities.

• Providing virtual case management services via videoconferences, teleconferences, and telephonic communications following the CMSA guidelines and ISYS protocols and procedures.

• Enthusiastically and professionally coordinate, facilitate, conduct, and complete virtual attendance at telemedicine appointments, with physicians, other medical professionals and ancillary providers in order to facilitate treatment recommendations in a timely manner.

• Initiate and conduct professional discussions with medical providers regarding diagnosis, treatment, and prognosis.

• Apply the case management process, education, and experience to facilitate appropriate and timely treatment and recovery of the injured worker with the goal of maximal recovery and maximal return to work.

• Provide proactive and timely communication, and coordinate collaboration with all parties involved in each case, by phone, and/or in writing.

• Support the injured worker’s progress towards achieving Maximum Medical Improvement and foster realistic and effective Return to Work opportunities by exploring viable options with all involved parties.

• Influence and collaborate with physicians by providing professional case management opinions and recommendations in order to proactively move cases towards Maximum Medical Improvement and provide cost containment for customers.

• Make recommendations to Claims Professionals/customers in order to ensure the best interests of the injured worker and claims progression, and ensuring the customer is informed of various potential outcomes and potential costs.

• Provide timely written and verbal communication of the employee’s medical status and treatment plan to the Claims Professional and other parties, as necessary, appropriate, and authorized.

• Create effective action plans for customer approval and implement the plan in order to enhance case outcomes and reduce complications, evaluate the success or failure of such plans, and modify plans as necessary to achieve effective and qualitative outcomes.

• Consider customer cost containment in all scenarios and recommendations.

• Keep in mind potential liability in all actions and make recommendations based on sound professional judgment and nursing/medical knowledge.

• A big picture perspective always. Keep in mind the agendas of the various parties and ensure that the case is progressing.

• Provide timely written and verbal communication of the injured workers’ abilities and restrictions to the Employer for coordination of return to work.

 

GREAT BENEFITS:

The ability to impact your own income through conscious effort is such a rare privilege and is one of the main perks of this special position. Compensation includes both biweekly salary and bonus. Ongoing bonus pay is not capped which means high earning potential is in your hands.

The opportunity to adjust your work schedule and navigate your responsibilities in a way that fits your personal preference and workstyle.

Rest and relaxation are important, so PTO (vacation) is accrued monthly. Plus, you can earn bonus PTO rewards annually and enjoy even more time off.

A benefits package with tax-deferred retirement program, a flexible schedule, medical, dental, and vision insurance, ancillary supplement health plans, Long-term disability insurance, and employee assistance program.

ABOUT ISYS CASE MANAGEMENT:

ISYS is an organization of people with big minds, big hearts, lots of spirit and good character whose mission is to work creatively and intensively to provide case management solutions and have a positive impact on those we serve. Providing forward focused care coordination and customer service in the workers compensation community since 1998, ISYS has an established brand reputation of delivering on our promise to provide consistent high quality catastrophic, rush, and onsite field medical case management services. Our company culture is based on living our values to:

Always do the right thing
Deliver excellence in everything we do
Encourage a Hug Your Customer philosophy
Communicate respectfully and proactively
Build relationships upon trust
Give generously
Pursue growth and learning
Be honest, authentic, grateful, and humble
Promote individual and economic liberty
Embrace the family spirit
Annual employee surveys are conducted as part of holding ourselves accountable to living these values and delivering on our promise to our employees. Annual team building, annual gatherings to acknowledge exceptional performance, and routine hugging are all part of our work family culture.

ISYS also has a Charitable Activities Committee that oversees and promotes employee involvement in our Pay it Forward program, which focuses on different ways to give back to the communities in which we live and work.

Thank you for your interest in working with ISYS!

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