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Registered Nurse (RN) - Workers' Comp/Occupational Health Telephonic Case Manager - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | san francisco, California |
About this job
Coventry Workers' Compensation Services offers workers' comp cost and care management solutions for employers, insurance carriers, and third-party administrators. With roots in both clinical and network services, Coventry leverages more than 30 years of industry knowledge and experience. In 2013, Coventry became a part of Aetna, joining together with common values and a common mission: empowering people to live healthier lives.
POSITION SUMMARY
The Workers' Compensation Telephonic Case Manager is responsible for telephonically assessing and analyzing workers' comp claims to evaluate injured employees' medical and vocational needs. The Workers Comp Telephonic Case Manager must facilitate the patients' appropriate and timely return to work, acting as a liaison between the patient/family, employer, providers, insurance, and other healthcare personnel. This is an onsite position in Patterson, CA with expected travel of 0-10%.
The Workers' Comp Case Manager will:
* Occupational Health Triage: 40% of time estimated; working with injured workers to assess, triage, provide care/treatment as appropriate, and/or refer out for medical treatment.Plan, implement, and coordinate all case management activities
* Telephonic case management : 60% of time estimated; work with injured worker, claims/risk management team, providers, vendors, employer to assist injured worker in achieving medical stability and facilitates return to work
* Communicate both in-person and telephonically with injured workers, medical providers, attorneys, employers, claims examiners and more
* Arrange specialty referrals, consultations, and services that correlate with clinical guidelines to expedite recovery
* Uphold applicable state and federal workers' compensation disability regulatory requirements
* Complete activity reports, Substantiating all case activities carried out and services rendered
REQUIRED BACKGROUND/EXPERIENCE:
* Active and unrestricted Registered Nurse (RN) license in state of employment
* Minimum 2 years of clinical nursing experience
* Strong computer skills
* Excellent communication skills
* Workers Compensation/ Occupational Health experience required
* CCM, COHN, CDMS, or CRRN license preferred
PREFERRED BACKGROUND/EXPERIENCE:
* Workers Compensation/ Occupational Health experience required
* CCM, COHN, CDMS, or CRRN license preferred
* Case Management experience preferred
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
POSITION SUMMARY
The Workers' Compensation Telephonic Case Manager is responsible for telephonically assessing and analyzing workers' comp claims to evaluate injured employees' medical and vocational needs. The Workers Comp Telephonic Case Manager must facilitate the patients' appropriate and timely return to work, acting as a liaison between the patient/family, employer, providers, insurance, and other healthcare personnel. This is an onsite position in Patterson, CA with expected travel of 0-10%.
The Workers' Comp Case Manager will:
* Occupational Health Triage: 40% of time estimated; working with injured workers to assess, triage, provide care/treatment as appropriate, and/or refer out for medical treatment.Plan, implement, and coordinate all case management activities
* Telephonic case management : 60% of time estimated; work with injured worker, claims/risk management team, providers, vendors, employer to assist injured worker in achieving medical stability and facilitates return to work
* Communicate both in-person and telephonically with injured workers, medical providers, attorneys, employers, claims examiners and more
* Arrange specialty referrals, consultations, and services that correlate with clinical guidelines to expedite recovery
* Uphold applicable state and federal workers' compensation disability regulatory requirements
* Complete activity reports, Substantiating all case activities carried out and services rendered
REQUIRED BACKGROUND/EXPERIENCE:
* Active and unrestricted Registered Nurse (RN) license in state of employment
* Minimum 2 years of clinical nursing experience
* Strong computer skills
* Excellent communication skills
* Workers Compensation/ Occupational Health experience required
* CCM, COHN, CDMS, or CRRN license preferred
PREFERRED BACKGROUND/EXPERIENCE:
* Workers Compensation/ Occupational Health experience required
* CCM, COHN, CDMS, or CRRN license preferred
* Case Management experience preferred
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
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