Case Manager, RN: PMA Companies

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: