EK Health is looking for a Full-Time Field Nurse Case Manager with Georgia CAT License for the greater Savannah, Georgia area.
NOTE: This position will require Workers Compensation experience and Utilization Review experience.
Case Management is a collaborative process to promote quality cost effective outcomes, which enhance the physical, social, and vocational health of individuals. This includes assessing, planning, implementing, coordinating, and evaluation of service options. A Case Manager provides technical knowledge and experience to the field of medical case management and strives to eliminate costly mistakes. The goal of a Case Manager is to assist the injured worker in receiving appropriate, cost effective medical care for their injury in a timely manner, and to expedite their return to work.
Position Logistics: Full-Time, Non-Exempt status, work from home with regular local travel
In addition to salary and benefits, we also offer our Field Nurse Case Managers: paid travel time, mileage reimbursement and phone and internet cost reimbursement.
- Completing in person visits at medical providers, which may include hospitals, physician offices, therapy providers, rehabilitation facilities or other providers as needed
- Completing in person visits with employers as warranted and requested
- Completing in person visits and/ or evaluations at injured employee’s homes as requested and warranted for the details of the case
- Completing referrals within computer database from either injury report or information gathered from the web-based system
- Performs 3-point contact on new files
- Reviewing and evaluating all medical correspondence, provider reports, & treatment plan history
- Providing necessary updates to all parties
- Evaluating clinical status of claimant and research for alternative options to treatment as warranted
- Communicating with the claim’s examiners regarding directives, and provides updates on file status
- Arranging transportation services when necessary and authorized
- Evaluating therapy facilities and their progress on specific cases
- Preparing comprehensive notes following any discussions had with IW, medical providers, claims examiners, and employers in the case file
- Perform a complete nursing evaluation to determine needs of patient
- Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation
- Upon authorization, implement this plan of care with patient, physician and health care providers
- Arrange for care/services as needed (home care, procedures, medication, equipment or supplies)
- Monitor the plan of care with modifications or changes suggested to the patient and physician as the need arises
- Coordinate information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any is involved)
- Determine the progress and the effectiveness of the care
- Prepare a monthly report of the patient’s progress and specific cost savings
- Evaluating clinical files ongoing and ensuring care is medically necessary
- Identifying cases that are not utilizing the MPN or PPO network providers, and appropriately redirects IW to the network providers, as applicable.
Requirements
- Graduate of an accredited school of nursing
- 5 years clinical experience as an RN outside of school
- Valid Georgia RN license in good standing with no restrictions
- Georgia CAT license
- Workers Compensation experience and Utilization Review experience
- Possesses and can demonstrate the professional and technical skills of a Registered Nurse
- Experience in Field Case Management, Workers’ Compensation experience required
- Experience in Home Health Care, Occupational Health considered a plus
- Excellent Written and Oral Communication Skills
- Excellent Interpersonal Skills
- Strong Organization Skills
- High comfort level with computers and computer programs (MS Word, MS Excel, Email)
- Ability to work independently with minimal supervision
- Ability to meet deadlines in a high pressure, time sensitive environment
EK Health Services has built a reputation for offering superior, goal-oriented Workers’ Compensation case management, utilization review, and bill review services. Our emphasis on medical excellence, superior service, impartial reporting, and case resolution is the driving force behind our consistent annual growth. We are excited about expanding our footprint across the United States as we continue to seek opportunities to Transform Managed Care.
Employees are provided with competitive compensation and benefits, including but not limited to medical, dental, vision, PTO, and 401k.
EK is an equal opportunity employer and makes all employment decisions on the basis of merit. EK does not practice, tolerate, or condone unlawful discrimination based on any protected status or the perception of such status.
Source: Indeed.com
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