Genex Services Medical Nurse Case Manager (RN) in Anchorage, Alaska

Overview

We are currently seeking a Field Nurse Case Manager (RN) in the Anchorage, Alaska area.

Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process. Working as an intermediary between carriers, attorneys, medical care providers, employers and employees, you will closely monitor the progress of the injured worker and report results back to the employer and insurance carrier. This will ensure appropriate and cost-effective healthcare services leading to a medically rehabilitated individual who is ready to return to an optimal level of work and functioning.

Responsibilities

Main responsibilities will include but are not limited to:

  • Using clinical/nursing skills to help coordinate the individual’s treatment program while maximizing quality of care and cost containment. Performance is monitored daily by Supervisors and/or Branch Manager.

  • Initial review and assessment of case information and referral objectives.

  • Verifying employee’s job Title/Description.

  • Contacting Employee to educate the employee in company policies and regulations; support employee in complying with prescribed treatment plan; assess employee motivation and resources (personal and interpersonal) that support return to work; establish and maintain Case Management goals and expectation of return to work in a safe and timely manner with the employee.

  • Contacting Provider to identify yourself and explain your role; ascertain treatment plan in order to assist patient compliance; request reports if appropriate; determine return to clinic date, referrals and projected return-to-work date.

  • Contacting Employer/Adjuster/Insurer to provide diagnosis, therapy, providers and projected return-to-work date; provide hard copy follow-up within 72 hours of original contact date; review with employer the employee and provider’s concerns.

  • Objectively and critically assesses all information related to the current treatment plan to identify barriers, clarify or determine realistic goals and objectives, and seek potential alternatives.

  • Maintaining daily records of all contacts.

  • Serving as an intermediary to interpret and educate the individual on his/her disability, and the treatment plan established by the case manager, physicians, and therapists.

  • Explaining physician’s and therapists’ instructions, and answers any other questions the claimant may have in an effort to facilitate his/her return to work.

  • Working with the physicians and therapists to set up medical assessments to develop and overall treatment plan that ensures cost containment while meeting state and other regulator’s guidelines.

  • Researching alternative treatment programs such as pain clinics, home health care, and work hardening. Coordinates all aspects of the individual’s enrollment into the programs, and then monitors his/her progress, in an effort to maximize cost containment and minimize time away from work.

  • Working with employers on modifications to job duties based on medical limitations and the employees functional assessment. Helps employer rewrite a job description, when necessary and possible, in an effort to return the client to the workplace.

  • Monitoring/evaluating the employee’s progress.

  • Supplying employer/adjuster/insurer with periodic reports agreed to in original contract, but not less than biweekly.

  • Providing input on the performance of support staff to their supervisor.

  • Tracking client updates by use of daily open listing.

  • Attending scheduled staff meetings and in-service programs.

  • Other duties as assigned.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Diploma, Associate or bachelors degree in nursing or bachelors degree (or higher) in a health or human services related field required. Masters level and/or advanced study in a health-related field desired.

  • Minimum of two (2) years full time equivalent of direct clinical care to consumers/clinical practice required. Case Management and/or Workers’ compensation-related experience strongly preferred.

  • A current, unrestricted RN (Registered Nurse) license or certification to practice a health or human services discipline in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline; or

  • In the case of an individual in a state that does not require licensure or certification, the individual must have a baccalaureate or graduate degree in social work, or another health or human services field that promotes the physical, psychosocial, and/or vocational well-being of the persons being served, that requires:

    1) A degree from an institution that is fully accredited by a nationally recognized educational accreditation organization; 2) The individual must have completed a supervised field experience, in case management, health, or behavioral health as part of the degree requirements; and 3) URAC-recognized certification in case management within four (4) years of hire as a case manager
  • Pursue URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN, or COHN) upon eligibility. Other state licenses/certification as required by law.

  • Valid driver's license required.

  • Experience in rehabilitation services industry, vocational/ occupational/ industrial nursing preferred.

  • Background in state workers’ compensation law and practices desirable.

  • Excellent interpersonal skills and phone manners. Excellent organizational skills.

  • Must be proficient in Microsoft Office suite with such programs as Word and Excel as well as have experience with internet searches and a comfort level with other software programs.

  • Ability to set priorities and work independently is essential.

  • Spanish speaking ability a plus!

Job ID 2017-1393

Job Locations US-AK-Anchorage

Category Field Case Management