Occupational Health Nurse Case Manager - Fully Remote in the US New

Description

Job Summary: 

The Occupational Health Nurse – Case Manager (OHN-CM) is responsible for providing nursing support activities/services for the case management program.

 

The OHN-CM’s primary role is to facilitate appropriate and timely health care with the focus on safe employee return-to-work and the return to maximum functionality. This is accomplished by providing the communication, coordination and education required to optimize outcomes across the continuum of health, disability, workers’ compensation, and work-life issues.

 

The OHN-CM employs best practices that require early intervention and the setting of realistic expectations for disability duration, return-to-work, and return to functionality. Care Coordination is a collaborative process that promotes quality of health care, client empowerment, and cost containment by supporting proactive intervention and reducing redundancies.

 

Schedule: Monday - Friday 7:00am - 3:00pm PST 

 

Essential Duties and Responsibilities

1. Provides initial contact with injured worker, employer, provider and other appropriate stakeholders (3 point contact) as soon as assignment is received. Discloses information regarding the role of case management and the rationale for the case management relationship. Submits claims per client specific guidelines.
2. Maintains contact and communicates with the adjuster assigned to the file through phone calls, email and written reports. Understands the limits of decision making-authority delegated by the adjuster to the nurse case manager and respects these limits. Keeps adjuster up to date with activity in case, case direction or secure authorization for services.
3. Demonstrates positive telephone interaction skills as evidenced by courteousness, open-ended questions to identify problems, and conversation focused on goal directed, time limited communication.
4. Acts as an advocate for the injured worker with all parties while maintaining the injured worker’s privacy and safety. As an advocate for the injured/ill worker in the compensation process, the case manager provides support, information, and education to improve employees’ knowledge about their health and self-care, and enhances their understanding of the health care treatment plan and  process.
5. Interacts with WorkCare staff, client site management and safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses.
6. Obtains medical history, diagnosis and treatment plan. Evaluates treatment against evidenced-based guidelines for appropriateness and effectiveness of care and sets realistic expectations for disability duration and return to work early in the treatment plan. Ensures all parties receive appropriate reports.
7. Performs effective telephonic case management for all illness/work-related incidents. Assesses and collects data regarding risk factors for delayed recovery and determines the impact on care, recovery and return to work.  Generates creative solutions to minimize or eliminate obstacles which prevent or delay RTW.
8. Arranges for prompt and appropriate medical treatment of an injured worker by qualified providers as per regulations. Ensures appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost.  Identifies excessive, ineffective or inefficient delivery of health care services and redirects care as needed and/or allowed.
9. Works collaboratively with employee to set return-to-work (RTW) goals, including expected return-to-work date. Works with medical providers to track progress and modify treatment plan until maximum medical improvement is achieved. Assures return-to-work clearances are safe and appropriate for all  occupational illnesses/injuries.
10. Must work productively and independently with minimal supervision, maintaining established standards and procedures. Captures proper billing in accordance with case activity.
11. Working over scheduled shifts may be required due to unpredictable nature of workloads.
12. Provide additional services to WorkCare as directed by Physician, Department Manager, or Supervisor. May be assigned to special projects or other duties as needed.
13. May include additional employer specific services: Manage short-term disability leave, Coordinate and assure proper delivery and oversight of medical and disability services for ADA and FMLA programs

Qualifications

Education/Licenses

• Associates Degree in Nursing required; Bachelor of Science in Nursing preferred.
• Must have a compact/multistate RN license, in good standing.  
• Case Management Certification preferred.
• Minimum 5 years of occupational health with 2-3 years’ experience as a telephonic nurse case manager.

Skills and Competencies

• Strong verbal, written and interpersonal communication skills. 
• Must be able to demonstrate the ability of maintaining privacy and confidentiality.  
• Strong critical thinking skills; problem solving, and decision making.   
• Ability to manage multiple priorities, with attention to detail and accuracy.  
• Ability to create and edit written materials.  
• Ability to communicate effectively to a variety of audiences.  
• Skill in organizing resources and establishing priorities.  
• Demonstrate cooperative behavior with colleagues, supervisors and clients. 
• Exhibits strong time management, organizational, and follow-through skills. 
• Ability to meet and exceed daily and weekly individual performance goals. 
• Ability to work independently as well as assisting other team members when needed. 
• Requires regular and predictable attendance and punctuality.                           

Computer Skills

• Must be competent in the Windows operating system environment, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed.

Physical Demands

• Requires sitting for long periods of time, working at a desk.
• Some bending and stretching could be required.
• Working under stress and use of computer/phone required.
• Manual dexterity required for use of computer keyboard.
• Occasionally may be required to stand, walk, stoop, kneel and/or crouch.
• Ability to lift/move up to 15 pounds and climb stairs

Work Environment

• Work Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. At home set up must meet all Company IT, privacy, and safety requirements.

 

The work hours are Monday - Friday 7:00am - 3:00pm PST.

Final compensation offered to the final candidate within this range depends on factors such as job-related knowledge, skills, experience, and qualifications. 

Benefits for this position include paid time off; medical, dental, vision, and critical illness insurance; HSA, HRA, and FSA; life and disability insurance; EAP; 401K; legal and identity theft coverage; pet insurance and more. 

All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other classification protected by applicable laws. WorkCare is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment.

Every qualified individual has the same opportunity for recruitment, hire, training, transfer, promotion, compensation, benefits, employee activities, and general treatment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other classification protected by applicable local, state, or federal law.