Telephonic Nurse Case Manager Job at W.R. Berkley, Alpharetta, GA

RnJhZUN3Q0VMV29Sd20vK3k0UzhkSHRnQ1E9PQ==
  • W.R. Berkley
  • Alpharetta, GA

Job Description

Company Details

Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is good for people and good for Berkley's insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology as a way to deliver the best outcome for injured workers and Berkley's operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers' compensation cases.

To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley's operating units with reliable results, and reduced time and expenses associated with case management.

Responsibilities

As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers.

  • Coordinate and implement medical case management to facilitate case closure
  • Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
  • Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
  • Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
  • Acquire and maintain nursing licensure for all jurisdictions as business needs require
  • Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
  • Document activities and case progress using appropriate methods and tools following best practices for quality improvement
  • Coordinate job analysis with employer to facilitate return to work
  • Engage and participate in special projects as assigned by case management manager
  • Occasionally attend on site meetings and professional programs
  • Review job analysis with physicians
  • Foster a teamwork environment
  • Maintaining and updating the Official Disability Guidelines (ODG) in reference to the injured worker status
Qualifications
  • Minimum of 2-years of experience in insurance rehabilitation and medical/vocational rehabilitation preferred
  • Minimum of 4-years medical/surgical clinical experience
  • Exhibit strong communication skills, professionalism, flexibility and adaptability
  • Possess working knowledge of medical and vocational resources available to the Workers' Compensation industry
  • Familiarity of the Dictionary of Occupational Titles (DOT) a plus
  • Demonstrate evidence of self-motivation and the ability to perform case management duties independently
  • Oral and written fluency in both Spanish and English a plus

Education

  • Graduate of an accredited school of nursing and possess a current RN license, Bachelors of Nursing preferred
  • Must be licensed in Minnesota and additional have applicable state certifications and/or licensures in the states where job duties are performed
  • Obtain other professional certifications as appropriate (CCM, CRRN, CDMS, COHN, CRC)
  • Earn Continuing Education Units to maintain certifications and licensures
  • Designated professional certification must be obtained within 2 years of hire date
Additional Company Details Company URL: berkleymms.com

The Company is an equal employment opportunity employer

We do not accept any unsolicited resumes from external recruiting agencies or firms.

The company offers a competitive compensation plan and robust benefits package for full time regular employees.

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements Travel Requirements
• Domestic U.S. travel required (up to 10% of time)

Job Tags

Full time, Flexible hours,

Similar Jobs

Capital Investment Advisors

Salesforce Administrator Job at Capital Investment Advisors

 ...Team is dedicated to employee growth both professionally and personally, and to making every CIA experience memorable. Salesforce Administrator We are seeking a detail-oriented and proactive Salesforce Administrator to join our technology team, reporting directly... 

The Borgen Project

Advocate Job at The Borgen Project

 ...Project has worked to support the passage of numerous bills that have benefitted close to 500 million people in developing countries Advocate This is a great entry-level volunteer position for someone looking to be part of The Borgen Project. Key Responsibilities... 

Danaher Manufacturing

Value Stream Operations Supervisor Job at Danaher Manufacturing

 ...Step into the heart of life sciences manufacturing At Cytiva, part of Danaher , we turn ideas into impact that can transform human health. Youll be immersed in a culture of belonging and continuous improvementinnovating at the speed of life alongside teammates who... 

Planet Fitness 84th & Giles

Omaha 84th & Giles Overnight Position - La Vista, NE Job at Planet Fitness 84th & Giles

 ...At Planet Fitness, we pride ourselves in creating a culture that empowers people to live a healthy lifestyle. Our goal is to assist our members and our employees to reach their full potential. We are currently looking for a high energy individual with a passion for helping... 

Think Tell Junction

Entry Level Project Coordinator Job at Think Tell Junction

Join Our Team as a Entry Level Project Coordinator Think Tell JunctionThink Tell Junction We are seeking an enthusiastic and organized...  ...or individuals looking to kickstart their career in project management and coordination. As an Entry Level Project Coordinator, you...