Specialty Case Manager

JOB DESCRIPTION

Essential Duties & Responsibilities

Performs a combination of duties in accordance with departmental guidelines :

1. Assesses disability status, makes recommendations, and identifies appropriate resources.

2. Accountable for gathering and coordinating medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and assigns length of disability.

3. Consults on case management issues in area of specialty and applies effective case management interventions.

4. Collaborates with medical and other providers to ensure appropriate treatment and return to work.

5.Facilitates job modifications when appropriateand educates involved parties regarding claims process and functionality as it relates to job requirements.

6. Documents according to jurisdictional, departmental andor accreditation requirements.

Reporting Relationship

Typically, Manager of Case Management

Skills, Knowledge, and Abilities

1. Strong knowledge of case management, specialty area, medical terminology and conditions, insurance industry as well as company policies and procedures.

2. Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs, and quality of service.

3. Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise, and effective manner.

4. Strong interpersonal skills with the ability to effectively interact with internal and external business partners.

5. Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks.

6. Knowledge of Microsoft Office Suite as well as other business-related software.

7. Ability to work independently.

Education and Experience

1. RN with BSN preferred. Eligible to sit for national case management certifications.

2. LNC or LCP designation is a plus but is not required

3. Typically a minimum five years diverse clinical background, with two or more years disability management experience preferred