- Strong understanding of medical terminology, procedures, and best practices
- Strong leadership skills to manage, coach, and support a team of telephonic case managers
- Ability to analyze complex medical information and make sound decisions
- Strong organizational and time management skills to effectively prioritize tasks
- Ability to work independently and collaboratively in a multidisciplinary team environment to manage priorities and meet deadlines
- Excellent verbal and written communication skills to effectively deliver training and interact with adjusters, insureds, and vendors
- Proficient understanding of traumatic injuries, related disabilities, and potential medical complications
- Thorough comprehension of Workers' Compensation Acts and working knowledge of the medical providers in the assigned territory
- Proficiency and expertise in utilizing medical treatment guidelines and disability duration guidelines
- Willingness to travel as needed for on-site visits and meetings
- Supervise a team of telephonic case managers, providing guidance, support, coaching and feedback
- Deliver training and education sessions to adjusters and insureds, ensuring a thorough understanding of medical programs and resources
- Interact with vendors, ensuring they comply with standards and deliver quality services to insureds
- Implement state managed care programs for insureds, including coordinating care, managing costs, and optimizing outcomes
- Provide oversight for catastrophic case management, ensuring appropriate and timely interventions for insureds with complex and high-acuity medical needs
- Throughout the life of an assignment review, analyze and critically assess medical records compared to evidence-based treatment guidelines; communicate findings and recommendations to the adjuster as part of the development of a medical action plan
- Active participation with claims team to review, establish, and execute action plan
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Supervisor, Nurse Consultant II - Dallas, TX, United States - Chubb
Description
The Workers Compensation Nurse Consultant is responsible for providing expertise and support in managing medical resources and programs.The Nurse Consultant serves as the primary point of contact for questions and assistance related to local medical programs within their assigned region(s).
They supervise telephonic case managers and oversee outside vendors, ensuring compliance with standards. The Nurse Consultant also implements state managed care programs and provides oversight for catastrophic case management.
This is a full-time remote position with a preferred location of Dallas, TX, however, qualified candidates in other locations within the Central time zone will be considered.
KNOWLEDGE AND SKILLS:
MAJOR DUTIES/RESPONSIBILITIES OF THE JOB:
