Field Nurse Case Manager

This position will cover the Allentown, PA with a travel radius of up to 2 hours. Full- and Part-time roles available. PRIMARY FUNCTIONThe Field Nurse Case Manager is responsible for assessment, planning, coordination, implementation and evaluation of injureddisabled individuals involved in the medical case management process. The Field Nurse Case Manager is responsible for submitting timely case reports and updates to insurance claims adjusters and employers. This will ensure appropriate, related and cost-effective healthcare services. PRINCIPAL DUTIES AND RESPONSIBILITIESEffectively manage assigned caseload of medicaldisability cases within company and regulatory guidelinesCommunication with claimants, medical professionals, claims staff and others to obtain information necessary to make sound medical decisions. In addition, responds to various written, telephone andor in-person inquiries regarding status of case.Respond to various written, telephone andor in person inquiries regarding the status of the caseCommunication with claimants, medical professionals, claims staff and others to obtain information necessary to make sound medical decisionsMakes case management recommendations based on physician's recommendations by completing case evaluations, assessing injurydisability severity, treatment plans, functional abilities and physical job requirements and establishing case specific target return to work dates.Maintains professional standard and ethical codes of conduct as required by the license(s) and professional certification(s) held by case managerApplies the case management process of assessment planning implementation, coordination monitoring and evaluationAttend physician appointments with injured worker(s), as neededComplies with company's billing practicesPeriodically assists with special projects assigned by SupervisorPeriodically serves as a resource regarding local jurisdictional guidelinesPerforms other related duties as requiredSCOPE, PURPOSE, AND FREQUENCY OF CONTACTSExternallyClaims AdjustorsEmployersInjured workers and family membersAttorneysVendorsTreating providers to include office staff, Hospitals, pharmacy, physicians and therapistInternallyCorporate StaffField SupervisorsField NursesDIRECTIONSUPERVISION OF OTHERSNADIRECTIONSUPERVISION RECEIVEDField Case Management SupervisorEDUCATION AND EXPERIENCE REQUIREMENTS3-to-5 years clinical experience required, workers' compensation experience is a plusGraduate from an accredited nursing, physical therapy, occupational therapy or physician assistant school requiredCurrent unrestricted license in the state where the position is based and other assigned states required by lawPreference for previous insurance workers' compensation case management, orthopedic, emergency room, critical care, home care or rehab care experiencePreferably holds one of the following certifications: Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Certified Rehabilitation Registered Nurse (CRRN) or Certified Occupational Health Nurse (COHN)State-specific registrations or certification, as required by various worker's compensation jurisdictionsKNOWLEDGE, SKILL, AND ABILITY REQUIREMENTSGood negotiation skills to successfully establish return to work dates and manage medical and disability treatment plansAttention to detailStrong Time management, Organizational skills and ability to multitaskAbility to work on multiple cases at the same timeStrong written and verbal communication skills to effectively communicate with claimant, medical professionals, employers, claims staff and othersWritten Abilities: Proficient grammar, sentence structure and written communication skills are requiredAbility to maintain confidentialityProficient Computer experience required, especially Microsoft Outlook, Word and ExcelAble to work as a team playerBilingual is a plus

Created: 2025-02-22