The Occupational Health Services, Claims Case Manager guides, facilitates and expedites the care and optimal recovery of patients and or employees having complex workers' compensations issues related to work injuries and illness.
Essential Functions:
- Initiates case management for complex workers' compensation cases including the development and monitoring of a case management plan
- Acts as a liaison between employees, employers and medical staff to coordinate care, appointments, referrals/consult authorization, and communicates work restrictions, extended time off and the need for further treatment
- Monitors patients who present with complex workers' compensation issues and consults with employers, patients and medical staff to facilitate returning the patient to usual and customary duties or to assist in initiating the rehabilitation process
- Manages OHS data from multiple sources which support case management, utilization patterns, practice guidelines and employer data
- Contributes to the patient and staff education concerning the workers' compensation system
- Interviews and counsels patients/families concerning workers' compensation, home environment, safety, availability of support networks, community facilities/resources and supplemental benefits
- Facilitates and promotes the identification of broad-based employer, employee, carrier and medical staff issues which are then referred to the OHS team for service improvement opportunities or activities
Qualifications:
Basic Qualifications:
- Two (2) years of related work experience in Workers' Compensation claims administration including coordinating/managing workers' compensation cases, modified work, risk management, and injury and illness prevention
- AA degree required
- Insurance Education Certification in Workers' Compensation or equivalent experience
- Self Insurance Administrator' Certificate preferred
- Demonstrated ability to utilize computer technology to help track control and report on program activity and results required
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.