Corporate Staffing Solutions recruits for Nurse Case Manager’s. We currently staff Field and Telephonic Nurse Case Managers who specialize in Workers’ Compensation.
A Workers’ Compensation Nurse Case Manager provides medical case management to individuals through coordination with the patient, physician, and employer. Possess excellent communication and organizational skills to interface with the client and claimants. Work well independently.
Essential Responsibilities:
Responsible for coordination of contact with provider, claimant, RTW contact and claims examiner.
Assessment of medical records for appropriateness, level of care provided.
Evaluate cases and review clinical information received with treatment protocols and guidelines, identify medical necessity and MD Director referral.
Ensure PPO direction, if unable to direct to PPO facility, negotiate with Non-PPO providers to ensure competitive rates to maximize cost savings or ensure direction to Bill Check for U&C review.
Work with treating physicians and return to work contact for facilitating return to work.
Prioritize and coordinate multiple responsibilities
Work closely with the Claims Examiner to update and advise of case status and potential problems.
Maintain confidentiality
Other duties as assigned by supervisor
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