Nurse/RN Field Case Manager - Kalamazoo / Jackson, MI

Concentra is an equal opportunity employer.

JOB SUMMARY
Assesses the medical and/or vocational components of injured worker's situation including, but not limited to, prior authorization, determination of appropriate level of care and utilization of services, concurrent review, retrospective review, development of discharge plans and assurance of quality and cost effectiveness. Acts as a liaison among patient/family, employer, insurance company, and healthcare personnel to ensure necessary care is provided promptly and effectively to restore injured worker's function, capacity and self-esteem.

MAJOR DUTIES AND RESPONSIBILITIES:
Primary Functions:
'Assesses and analyzes injured worker's medical and/or vocational status and develops a viable, realistic service plan.
'Meets with clients in their homes, work-sites, physician's or therapist's office to provide on going case management services.
'Develops a plan of care for patients from admission to discharge.
'Monitors patient progress toward desired outcomes through assessments and evaluations.
'Communicates both in-person and telephonically with client, medical providers, attorneys, employers, insurance carriers, etc.
'Develops and administers education and prevention programs.
'Develops guidelines for working with patients, healthcare management companies, insurance companies or other third party payers to determine quality, cost-effective care. Applies all special instructions required by individual insurance carriers and referral sources.
'Applies all laws and regulations that apply to the provision of rehabilitation services.
'Testifies when called upon to do so, to substantiate any casework or reports that may be seen as relevant to hearing involving client.
'Evaluates outcome of patient care.
'Prepares reports and other required paperwork as documentation of all casework activities at
'May arrange referrals, consultations, therapeutic services, and confers with other specialists on course of care and treatment.
'Attends staff meetings
'Participates in sales activities.Job Requirements
EDUCATION/CREDENTIALS:
'Licensed RN in accordance with state laws of jurisdiction
'Obtaining and maintaining, CCM, CIRS, CDMS, CRRN or CRC designations are encouraged; these designations are required where dictated by state regulations.


JOB RELEVENT EXPERIENCE:
'2 ' 4 years case management experience

JOB-RELATED SKILLS/COMPETENCIES:
'Knowledge of laws and regulations that govern delivery of rehabilitation services
'Knowledge of worker's compensation and disability industry
'Therapy and counseling knowledge
'Knowledge of human behavior and performance
'Administration and management knowledge
'Customer and personal service knowledge including needs assessment, meeting quality standards for services and evaluation of customer satisfaction
'Education and training
'Reading comprehension
'Judgment and decision making
'Critical thinking
'Active listening
'Speaking to effectively convey information to supervisors, peers, or customers
'Instructing skills to teach others
'Use of scientific rules and methods to solve problems
'Writing
'Oral expression
'Problem sensitivity
'Manual dexterity
'Speech clarity
'Deductive reasoning
'Static strength
'Written comprehension
'Wrist-finger speed
'Monitoring of self, other individuals to take corrective action
'Social perceptiveness
'Service orientation
'Documenting and recording information
'Reliable transportation and current driver's license
'Ability to meet deadlines
'Computer literate
'Thoroughly developed time management and organization skills.
'Ability to work without supervision

WORKING CONDITIONS:

'Clinic environment
'Automobile