Case Manager, RN
Location: Wilmington Delaware
Description: PMA Capital Corporation is looking of Case Manager, RN right now, this job will be placed in Delaware. Detailed specification about this job opportunity kindly read the description below. This position also may be based in our Blue Bell, PA office. As a member of our managed care team, you will provide case management services to non-catastrophic worker's compensation claims for self insured clients. Utilize your nursing experience to provide case management service telephonically or in person to injured employees of our clients. You will use your knowledge of workers compensation and medical treatment experience to establish short and long term goals to achieve optimal medical outcomes with minimal lost time from work in accordance with legal statutes policy provisions and company guidelines.
Essential Functions:
Provide case management services to non-catastrophic worker's compensation cases.
Apply the case management process of assessment planning implementation coordination monitoring and evaluation.
Serve as an advocate for the injured worker within the parameters of the applicable jurisdiction.
Develop and implements action plans for non-catastrophic worker's compensation cases.
Deliver quality services by adherence to corporate policies and procedures best practices client special handling instructions and applicable regulatory requirements.
Comply with corporate time and billing policies.
Maintain professional standards and ethical codes of conduct as required by the nursing license(s) and professional certification(s) held by the case manager.
Utilize highly developed telephonic skills to successfully conduct services as appropriate.
Follow referral criteria for involvement of field case management services as appropriate.
Adhere to assignment criteria for either task or full case management as appropriate.
Plan travel and work activities for efficiency in accordance to corporate policies and best practices as appropriate.
Develop relationships and knowledge of community resources to facilitate cooperation and involvement of parties as appropriate.
Maintain safety awareness and practices when working in the field environment as appropriate.
Benchmark medical treatment plans to evidence based treatment guidelines.
Communicate effectively verbally and in writing with internal and external parties on a wide variety of claims and account issues.
Develop case action plans to facilitate non-catastrophic case resolution.
Provide a high degree of customer service to clients including participation in claims reviews stewardship meetings and similar account-specific meetings.
Qualifications:
Bachelors degree in Nursing, Healthcare and or Occupational Medicine
Active Registered Nurse (RN) license(s) for Pennsylvania and Delaware; state specific registrations or certifications as required by various Worker's Compensation jurisdictions required.
Certified Case Manager (CCM), Certified Disability Management Specialists (CDMS), Certified Rehabilitation Registered Nurse (CRRN), and/or Certified Occupational Health Nurse (COHN) professional designation(s) preferred.
Minimum of three years experience in a clinical facility in orthopedics, neurology, critical care, emergency trauma, general surgery, rehabilitation, physical medicine and/or occupational health.
Knowledge and solid understanding of all regulatory requirements for assigned jurisdictions related to worker's compensation medical management.
Demonstrated knowledge of current medical treatments and transitional work practices encountered in worker's compensation cases.
Proven technical proficiency through timely consistent execution of best case management practices.
Computer literacy in the use of email MS Office Product Suite (i.e. Word Excel), proprietary PMA systems and internet queries for research.
As a leader in the property and casualty insurance industry with multiple locations, our clients choose PMA Companies because we understand that excellent service begins with our employees. Our working relationships with clients are marked by professionalism, execution and accountability and our company culture is centered on teamwork. This combination has created a supportive work environment that encourages personal and professional growth.
We offer a very competitive compensation package including two retirement contribution savings plans: a 401(k) with dollar for dollar match on the first 5% of salary and a company funded retirement contribution plan; tuition reimbursement and much more!
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to PMA Capital Corporation.
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This job starts available on: Wed, 04 Jul 2012 09:59:18 GMT