3 clinic nurse medical case manager jobs found

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance with the appropriate...

Reporting directly to the Medical Management Supervisor, the Workers' Compensation (WC) Case Manager supports the WC Department by following the best practices associated with managing of the injured worker effectively and efficiently. The position requires the nurse to work and communicate with other members of the Medical Management team in addition to the WC Claims team, WC Claims Supervisors, and other team members. The WC Team Lead also interacts with the associated injured parties or their legal representatives, medical providers, and other departments within NJM, as needed. The official NJM job title is Medical Management Coordinator. Essential Duties and Responsibilities: Demonstrate knowledge, skills, and competency in the application of case management standards of practice. Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.  Facilitate...

Overview PRIMARY PURPOSE:   The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical treatment and engagement of the injured worker to achieve a safe and reasonable return to work. This position requires interaction with physicians, other medical providers, claims professionals, supervision, injured employees and employers....