MontgomeryRecruiter Since 2001
the smart solution for Montgomery jobs

Nurse - Medical Case Manager

Company: Crawford & Company
Location: Montgomery
Posted on: September 13, 2019

Job Description:

Excellence In Everything We TouchPosition SummaryThis is a work from home position requiring --local field case management travel.-- Candidate must reside within the Montgomery, AL region.-- Prior WC/Case Management experience a plus.-- National Certification-- (CCM, COHN, CRRN) a plus.--To provide effective case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and CMSA Standards of Practice and Broadspire Quality Assurance (QA) Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers' Compensation, Group Health, Liability and Disability.--Responsibilities-- Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitate timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer.-- Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services.-- Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem-- solving by appropriate use of research and resources. May perform other related duties as assigned.--Requirements Associate's degree or relevant course work/certification in Nursing is required. Minimum of 3-5 years diverse clinical experience and one of the below Certification as a case manager from the URAC-approved list of certifications; A bachelors (or higher) degree in a health or human services related field; A registered nurse (RN) license. Valid RN licensure in the state(s) the incumbent works in. Must meet specific licensing requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is highly preferred.-- If not attained, must plan to take certification exam within proceeding 24 months and have a minimum of 4 years WC case management experience/demonstrated excellent performance in a similar position with another organization. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.--Preferred: BSN Degree is preferred.About Us--Think all TPAs are the same? Think again. With Broadspire, our leading global third-party administrator (TPA), Crawford & Company is the consultative outsourcing partner that adapts to businesses' needs and challenges at any point of the claims processing journey. We offer casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics.As part of the One Crawford family, Broadspire brings together the best and brightest people in the industry to deliver smart, thoughtful solutions to our clients, and we are guided by our collective value system: RESTORE.At Crawford, we: Respect our culture of integrity and ethical behavior, while embracing the unique talents of the individual and encouraging an ownership mentality among everyone. Are Empowered to advance the company mission and take ownership of our individual career progression. Promote Sustainability through a corporate culture in which employees are good stewards of their communities. Emphasize Training and an environment where employees continually seek and share knowledge and are engaged and satisfied with their work. Are One Crawford, embracing a global mindset that's inclusive, agile, mission-focused, and customer-focused. Give Recognition, participating in an environment where people are rewarded for jobs well done. Embody an Entrepreneurial Spirit, sharing a passion to succeed, innovate, and outpace our competitors.We believe in leading by example - at work and in our communities. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve.--Though our reach is vast, we proudly operate as One Crawford: united in mission, vision and values. Learn more at www.crawfordandcompany.com.In addition to a competitive salary, Crawford offers you: Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries On-going training opportunities through every stage of your career Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

Keywords: Crawford & Company, Montgomery , Nurse - Medical Case Manager, Healthcare , Montgomery, Alabama

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Pediatric Opening Near Birmingham AL with partnership (Physician #6951
Description: Seeking Pediatrican for a BC/BE Pediatrician to join a busy private practice with 2 Pediatricians and 1 Nurse Practitioner. Three Year
Company: Keith A. Long LLC, dba. Source Medical
Location: Birmingham
Posted on: 09/20/2019

Urgent Care (Physician #)
Description: Urgent Care opening in Birmingham, Alabama. br BC/BE Urgent Care Provider who is BC/BE in Family Medicine or Internal Medicine. br ul li Walk-in Clinic li Employed Full-time Opportunity li (more...)
Company: Spot On Recruiting, Inc.
Location: Birmingham
Posted on: 09/20/2019

MICU Medical Intensive Care RN Travel Nurse
Description: Nationwide Travel Nurse Jobs - Medical Intensive Care RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: HealthCare Travelers
Location: Birmingham
Posted on: 09/20/2019


Breast Surgery Job in Birmingham, Alabama (Physician #)
Description: Breast Surgeons needed in Birmingham, AL Join a highly respected 100 Breast Surgery Practice. There is a multi-state referral base with a patient population in excess of 12,000. A great partnership opportunity (more...)
Company: HDA MD Staff
Location: Birmingham
Posted on: 09/20/2019

Loan Forgiveness and Minimal Call in Birmingham, AL (Physician #)
Description: Wonderful opportunity to join a growing practice with a patient base waiting to greet you This is a full-time traditional Endocrinology position, primarily
Company: The Curare Group, Inc
Location: Birmingham
Posted on: 09/20/2019

Gastroenterology Physician Job near Birmingham, Alabama (Physician #)
Description: Gastroenterology Job in Birmingham, AL A busy and expanding facility is in need of a BC/BE gastroenterologist.
Company: HDA MD Staff
Location: Birmingham
Posted on: 09/20/2019

Psychiatry Collaborating Physician (Physician #)
Description: TeamHealth has an excellent opportunity for a Psychiatrist to join our behavioral health
Company: TeamHealth
Location: Birmingham
Posted on: 09/20/2019

MedSurg Travel RN Needed in Birmingham, AL
Description: Position DescriptionMed/Surge Nurses provide direct and individualized nursing care to patients based on the application of scientific nursing principles. In addition to general nursing care, responsibilities (more...)
Company: Travel Nurses, Inc.
Location: Birmingham
Posted on: 09/20/2019

RN Psych IM2 FT Days Brookwood BMC Up to 15K Bonus Potential
Description: SummaryThis role provides direct clinical patient care. br The role will assume responsibility for assessing, planning, implementing
Company: Tenet
Location: Birmingham
Posted on: 09/20/2019

Locum Tenens Hospitalist Opportunity Outside Birmingham, AL
Description: Hospitalist opening in Birmingham, Alabama. This and other physician jobs brought to you by DocCafe.com
Company: VeloSource
Location: Birmingham
Posted on: 09/20/2019

Log In or Create An Account

Get the latest Alabama jobs by following @recnetAL on Twitter!

Montgomery RSS job feeds