Responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patient’s appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.
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Assesses and analyzes an injured employee’s medical and vocational status. Develops a plan of care to facilitate the patient’s appropriate and timely return to work.
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Interviews patient’s in their homes, work-sites, or physician’s office to provide ongoing case management services.
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Monitors patient progress toward desired outcomes through assessment and evaluation.
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Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers. Prepares all required documentation of case work activities.
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May arrange referrals, consultations and therapeutic services for patients. Confers with specialists concerning course of care and treatment.
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Develops and administers educational and prevention programs.
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Applies all laws and regulations that apply to the provision of rehabilitation services. Applies all special instructions required by individual insurance carriers and referral sources.
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Testifies as required to substantiate any relevant case work or reports.
- Performs other duties as assigned.
Qualifications:
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Registered nurse with current state (CA) RN license.
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Previous (3 or more years) case management experience required.
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Bachelor’s degree or equivalent experience preferred.
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CCM, CRRN, COHN, or CDMS eligibility or current certification encouraged. These designations are required where dictated by state law.
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Must be bi-lingual in Spanish.
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Knowledge of laws and regulations governing delivery of rehabilitation services.
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Knowledge of workers’ compensation and disability industry
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Strong problem solving and analytical skills.
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Ability to work independently, this a work from home position.
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Strong computer skills with wireless devices such as laptop and smart phone. Able to work on automated files
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Regular local travel required.
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Demonstrated communication, organizational, and interpersonal skills.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Orange County, CA, US
Organization: 43000 - CHC Workers Compensation
Schedule: Full-time
Job Posting: 2012-12-06 00:00:00.0
Job ID: 1212515