- 35% - Conducts comprehensive initial interviews with injured worker regarding the injury, medical and injury history, claim history, employment issues and psycho-social factors. Gathers initial medical information. Assesses information from all sources and benchmarks the injury and treatment projections against evidence based treatment guidelines.
- 25% - Routes claims to the appropriate claim representative, nurse case manager and/or external claims consultant based on identified injury types and bio-psychosocial return to wellness barriers. Catastrophic or complex cases will be urgently referred to the appropriate strategic partner. Facilitates transition of care between medical intake staff to medical management partners to ensure that appropriate plans are in place to control and change identified biopsychosocial factors which impact return to wellness and treatment.
- 15% - Uses appropriate research to support recommendations and summarizes medical literature.
- 15% - Re-evaluates selected claims at expiration of initial estimated length of disability to determine if returned to wellness. If has not returned with restrictions (if out of work), or returned to full duty work, evaluates and determines the appropriate medical management tools to be used.
- 5% - Continue professional growth and development through the attendance and participation in insurance related events/functions, seminars, classes and conferences. Provide summary of new learning to appropriate groups.
- 3% - Assists the Director of Medical Care Management with special projects as assigned.
- 2% - Participates in Paradigm calls as needed.
- Active unrestricted Registered Nurse license(s) for assigned jurisdiction(s) with a minimum of 5 years' experience in any of the following specialties: orthopedics, neurology, critical care, emergency trauma, general surgery, rehabilitation, occupational health, or workers' compensation case management. Bachelor's degree preferred.
- Current professional certification (or completion within 3 years of hire date) in one or more of the following:
- Certified Case Manager (CCM)
- Certified Disability Management Specialist (CDMS)
- Certified Rehabilitation Registered Nurse (CRRN)
- Certified Occupational Health Nurse (COHN)
- Certified Legal Nurse Consultant (CLNC)
- State specific registrations or certifications, as required by various workers' compensation jurisdictions.
- Advanced knowledge of workers' compensation treatment arena, evidence based medicine, and jurisdictional requirements are necessary.
- Maintains professional standards and ethical codes of conduct as required by the nursing license(s) and professional certification(s) held by the case manager.
- Knowledgeable in various software packages required to provide effective office support, including Microsoft Office products, such as Word, Excel, PowerPoint, Outlook.
- Ability to communicate effectively both verbally and in writing with all levels of the organization as well as with outside customers and vendors.
- Attention to detail in processing all information, establishing priorities and meeting deadlines.
- Excellent analytical and problem solving skills, including formulating logical and objective conclusions.
- Ability to maintain confidential information.
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workers compensation early intervention nurse specialist - Charlotte, NC, United States - ProAssurance Corporation
Description
An exciting opportunity exists to join the ProAssurance family of companiesWe are a specialty writer of professional liability, products liability and workers' compensation insurance.
With approximately 1,000 team members operating in all 50 states, we are well-positioned to offer career opportunities to individuals interested in professional growth.
This position supports our workers' compensation line of business, Eastern Alliance. Preference is for this position to be based out of our Charlotte NC office location.
Eastern Alliance offers a fully flexible work arrangement where its team members report into an office as needed for team meetings, department meetings, companywide meetings and special events.
The primary responsibility of the Early Intervention Nurse Specialist is to consistently execute the Company's ecovery Return to Wellness philosophy and business model that leads to better outcomes for our injured workers and insureds.
The primary responsibility of this position includes assessment of selected claims for early assignment of case management services with transitioning of medical management to the appropriately skilled professional.
The Earl Intervention Nurse Specialist will also follow a select a group of injured workers to determine changes that necessitate the use of additional claims and medical management tools.
Essential Functions:
Secondary Functions:
Knowledge, Skills and Abilities Required:
$72, $120,400.00
The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range.
Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.
