The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.
RN Field Case Manager
IF YOU CARE, THERE’S A PLACE FOR YOU HERE
For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.
Take advantage of a generous sign on bonus. We also offer a robust benefits package that starts on your first day!
Field Case Manager will cover our San Jose, CA region -must reside in this region/area of California.
PRIMARY PURPOSE: To facilitate progressive medical treatment/rehabilitation and/or timely return to work of injured worker; and to act as liaison for involved parties.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Assesses and analyzes injured worker's medical and vocational status.
- Develops progressive plan of care to facilitate medical recovery and progressive return to work.
- Manages one-time task assignment or full field case management referral to meet with attending physician, injured worker and/or employer to clarify medical and/or vocational claim related information which could not be obtained through correspondence or telephonic attempts by claims team.
- Collaborates with members of the health care team to provide ongoing case management services.
- Acts as liaison for involved parties in the worker's compensation injury by communicating in person and telephonically with the patient/caregiver, attorneys, employer, claims examiners, telephonic nurse case manager, return to work specialists, vocational rehabilitation supervisor, provider(s), ancillary provider(s) and health care team.
- Monitors injured employee's progress towards appropriately established outcomes through continued assessment and evaluation.
- Coordinates necessary referrals, consultations, and therapeutic services for the injured employee.
- Completes the interview process with the patient/caregiver in the home, worksite, ancillary location or physician's office for current and ongoing assessments and evaluations.
- Assists in the development of continued care plans as necessary to include patient education and prevention programs.
- Testifies as needed to substantiate relevant case work or reports.
- Confers with medical treating providers concerning the course of care and treatment per clinical guidelines.
- Educates medical providers on appropriate disability and treatment guidelines as necessary.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
Education & Licensing
Current state RN licensure required. Bachelor's degree from an accredited college or university preferred. CCM, CRRN, COHN, CDMS eligibility or current certification preferred.
Six (6) years of related work experience or equivalent combination of education and experience required to include three (3) years case management experience in any managed care or home health environment.
Skills & Knowledge
- Knowledge of laws and regulations pertaining to rehabilitation and HIPPA
- Knowledge of workers' compensation and/or disability
- Excellent oral and written communication skills
- PC literate, including Microsoft Office products
- Strong problem solving skills
- Ability to work independently
- Excellent interpersonal and negotiation skills
- Ability to meet or exceed Performance Competencies
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
- Case Management
- Claim Processing
- Clinical Works