Telephonic Nurse Case Manager Job at W.R. Berkley, Appleton, WI

S1hMTHkwQm1iOWRrbDVhQVovd0xYUi9ONkE9PQ==
  • W.R. Berkley
  • Appleton, WI

Job Description

Company Details

Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is good for people and good for Berkley's insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology as a way to deliver the best outcome for injured workers and Berkley's operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers' compensation cases.

To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley's operating units with reliable results, and reduced time and expenses associated with case management.

Responsibilities

As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers.

  • Coordinate and implement medical case management to facilitate case closure
  • Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
  • Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
  • Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
  • Acquire and maintain nursing licensure for all jurisdictions as business needs require
  • Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
  • Document activities and case progress using appropriate methods and tools following best practices for quality improvement
  • Coordinate job analysis with employer to facilitate return to work
  • Engage and participate in special projects as assigned by case management manager
  • Occasionally attend on site meetings and professional programs
  • Review job analysis with physicians
  • Foster a teamwork environment
  • Maintaining and updating the Official Disability Guidelines (ODG) in reference to the injured worker status
Qualifications
  • Minimum of 2-years of experience in insurance rehabilitation and medical/vocational rehabilitation preferred
  • Minimum of 4-years medical/surgical clinical experience
  • Exhibit strong communication skills, professionalism, flexibility and adaptability
  • Possess working knowledge of medical and vocational resources available to the Workers' Compensation industry
  • Familiarity of the Dictionary of Occupational Titles (DOT) a plus
  • Demonstrate evidence of self-motivation and the ability to perform case management duties independently
  • Oral and written fluency in both Spanish and English a plus

Education

  • Graduate of an accredited school of nursing and possess a current RN license, Bachelors of Nursing preferred
  • Compact state license greatly preferred
  • Ability to obtain license in Minnesota and additional have applicable state certifications and/or licensures in the states where job duties are performed
  • Obtain other professional certifications as appropriate (CCM, CRRN, CDMS, COHN, CRC)
  • Earn Continuing Education Units to maintain certifications and licensures
  • Designated professional certification must be obtained within 2 years of hire date
Additional Company Details

The Company is an equal employment opportunity employer

We do not accept any unsolicited resumes from external recruiting agencies or firms.

The company offers a competitive compensation plan and robust benefits package for full time regular employees.

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements Travel Requirements
• Domestic U.S. travel required (up to 10% of time)

Job Tags

Full time, Flexible hours,

Similar Jobs

University of Kansas

Health Educator | University of Kansas Job at University of Kansas

 ...The Health Education Resource Office (HERO) is a source for KU student wellness through partnerships that support innovative approaches...  ...include, but are not limited to: alcohol, tobacco, and other drugs, sexual health and healthy relationships, and mental health and self-... 

University of California Agriculture and Natural Resources

Community Education Supervisor 2 Job at University of California Agriculture and Natural Resources

 ...Community Education Supervisor 2 The home department for this position is UCCE Yolo County. While this position normally is based in Davis, CA, this position is eligible for hybrid flexible work arrangements, for applicants living in the State of California, at this... 

Lincoln Community Health Center

Licensed Clinical Addiction Specialist Job at Lincoln Community Health Center

 ...LICENSED CLINICAL ADDICTIONS SPECIALIST (LCAS) BEHAVIORAL HEALTH CLINIC POSITION DESCRIPTION: Provides initial assessment, diagnoses, and evaluation services for adult patients. Provides treatment services for adult patients with substance use disorders. May... 

Coffeyville Regional Medical Center

Human Resources - Student /General Application Job at Coffeyville Regional Medical Center

Summary: This posting is only for Medical Field College Students to post their application and resumes until Graduation. Your application and resume will be maintained and filtered into hospital job postings as they come available.

Amphitheater Public Schools

Bus Driver/Trainee Job at Amphitheater Public Schools

 ...PositionDetails REQUIRED: High school diploma or GED Bus Driver trainees must possess a valid Arizona driver's license Must meet...  ...state certification Equivalent combination of education/training/experience Multiple Positions Available Full job...