Medical Case Management Specialist & Nurse Consultant

Our client is one of Montana's largest workers' compensation carriers. They strive to promote safe workplaces, prevent injuries, and effectively manage claims and lower rates by providing exceptional customer service and industry leadership in everything they do.

They presently offer opportunities as Senior Medical Case Manager and Strategic Nurse Consultant.

As Case Management Specialist:

You'll resolve issues across teams and identify technical development needs for existing staff.

You'll provide staff orientation and development, conduct quality reviews for medical case and strategic claim management on a quarterly basis, and develop or coordinate specialized training as indicated. You'll analyze medical claims management issues with other claims professionals through communication, coordination and facilitation of information.

You'll lead and facilitate monthly case manager and strategic nurse meetings; provide orientation for new hires.

Nurse Consultant Responsibilities

Conduct intensive files reviews, develop and implement long range action plan strategies that either lead to claims closure or medical stability. Serve as a medical resource for injured employees relating to diagnosis, treatment plan, or medical services. Research and analyze provider treatment plans with evidence-based best practices and negotiate an acceptable course of action with multiple providers. Analyze medical claims management issues with other claims professionals through communication, coordination and facilitation of information, and negotiate appropriate treatment plans with medical providers

Evaluate on-going services provided to ensure provider compliance with negotiated treatment plan and medical care is effective.

Qualifications:

Requires a RN, APRN or PA license with four (4) years of clinical experience plus two (2) years of workers compensation experience and two (2) years experience in design, development, implementation, evaluation, and supervision of a medical management program. Master's degree in related field is preferred but not required.

Please contact Scot Dickerson for immediate confidential consideration and additional details. Email: [Click Here to Email Your Resumé]. Phone: 515-987-0242 Fax 515-987-0004 See our website at, www.csgrecruiting.com/ins_opportunities.htm for a complete listing of national opportunities.

Capstone Insurance Search Group is a search firm dedicated to the insurance industry. We work nationally with expertise that spans top executives, middle management and technical level positions. We can provide assistance with a variety of product lines to include Property and Casualty, Life, Health, Disability, Annuity and Pension. We will provide you with a service that is of the highest degree of confidentiality, professionalism and integrity.