Position Overview: The Registered Nurse provides medical case management for the Public Sector Workers' Compensation Program and Return-to-Work Program, including clinical assessment, care coordination, utilization review, medical documentation, and return-to-work planning. Coordinate care among injured workers, treating physicians, specialists, rehabilitation providers, employers, supervisors, claims examiners, and agency representatives.
The Registered Nurse provides medical case management for the Public Sector Workers' Compensation Program and Return-to-Work Program, including clinical assessment, care coordination, utilization review, medical documentation, and return-to-work planning.
Why You'll Love Working Here:
Competitive rate of $52/hour providing specialized medical case management for workers' compensation and return-to-work programs.
Temporary, part-time (as-needed) position.
Part-time / as-needed schedule, Monday–Friday.
No work on District holidays or administrative closure days without prior written approval.
Valuable experience in a collaborative, supportive government office setting.
Mission-driven work improving outcomes for injured workers through comprehensive medical case management and return-to-work planning.
Qualifications:
Graduation from an accredited professional nursing program recognized by the applicable state accrediting authority.
Current Registered Nurse license in the District of Columbia.
At least one year of specialized professional nursing experience involving medical assessment, planning, implementation, utilization review, and evaluation of patient progress.
Clinical experience in orthopedics, neurology, rehabilitation, or utilization review.
Skilled in clinical assessment, medical case management, care planning, and utilization review.
Knowledge of workers' compensation medical issues, healthcare regulations, return-to-work planning, and treatment review.
Medical-record analysis, professional documentation, and case-status reporting.
Proficiency with Microsoft Office and electronic medical or claims systems.
Analytical, interpersonal, presentation, and written and verbal communication skills.
Confidential information handling and privacy compliance.
Key Responsibilities:
Provide comprehensive medical case management for public-sector workers' compensation and return-to-work programs.
Develop, implement, monitor, and revise individual case management plans that support recovery and safe return to work.
Coordinate care among injured workers, treating physicians, specialists, rehabilitation providers, employers, supervisors, claims examiners, and agency representatives.
Review medical records, treatment plans, utilization requests, and supporting documentation for medical necessity, appropriateness, and workers' compensation compliance.
Conduct utilization review, treatment-plan review, and medical-billing review.
Identify claims appropriate for return-to-work initiatives and support transitional duty assignments and workplace accommodations.
Establish return-to-work status, projected recovery timelines, maximum medical improvement targets, work restrictions, and functional capacity recommendations based on medical evidence and provider input.
Monitor injured workers before and after return to work and communicate case status and treatment progress to stakeholders.
Prepare medical status reports, case summaries, recommendations, and claim-support documentation.
Provide consultation, guidance, and training on medical management, return-to-work strategies, injury prevention, and transitional duty.
Present medical findings and professional recommendations during claim reviews, mediations, hearings, and other proceedings.
Maintain complete case records and safeguard confidential medical and personnel information.
Perform other related duties supporting the workers' compensation and return-to-work programs.