RN Case Manager

Minutemen OhioComp is currently seeking a Full-Time RN Case Manager for our Cleveland office. Candidates need to have at least 2 years of clinical experience. Certified Case Manager (CCM) and familiarity with Ohio BWC desired but Occupational Medicine and or Orthopedic background helpful. We offer an excellent benefit package, daytime hours, 5 day work week. Looking for team players with excellent communication and computer skills. Effective analytical and problem solving ability.

Responsible for providing case management services to injured employees covered under the Ohio Bureau of Workers' Compensation program. Acts as a liaison between the company, employer, injured worker (IW), provider of record, and any additional parties involved in the management of a claim. Monitors the IW's progress towards meeting goals and reports progress back to the employer. The goal of our case managers is make sure the IW is receiving the best medical care possible and to facilitate a safe and quick return to work.

Duties and Responsibilities:

• Gathers relevant data and obtains additional information from the injured worker, employer, all providers of care and primary treating physician in order to initiate case management of the claim.
• Writes a baseline comprehensive assessment including the Injury/Disease Profile, Barriers and Safety Issues, and Psychosocial and Cultural Assessments.
• Using the information gathered in assessment, formulate a case management plan that is specific to the individual using both independent and collaborative approach.
• Writes case management plan for each claim admitted with input from the injured worker (IW), provider, and employer. Case management plan includes specific, measurable, and achievable goals for the injured worker for a realistic and timely return to work. Plan to include interventions that will be identified as action plans that include the what, where, and how of the intervention.
• Monitors and evaluates the case management plan by reviewing test results, progress reports and assessments from providers and vendors as well as the employer's ability to accommodate the injured worker.
• Monitors the injured worker's progress toward meeting goals.
• Implements the plan of care by calling the injured worker to provide information and support as well as making sure there are no barriers to the injured worker successfully completing his/her plan of care.
• Collaborates with the injured worker and members of the health care team and monitors interventions to evaluate effectiveness of the case management plan.
• Empowers the injured worker and any caregivers through education and involvement allowing them to make informed health care decisions.
• Practices case management within the scope of their licensure (based on the standards of the discipline).
• Maintains regular telephonic contact with the injured worker to provide support and education regarding the injury and care.
• Rate negotiation as necessary.
• Implements the case management plan by working collaboratively with the employer, employee and provider. May recommend treatment alternatives to the IW and provider based upon established guidelines and standards of care.
• Periodically evaluates the case management plan for necessary revisions and documents this in the case file.
• Maintains confidentiality and adheres to ethical, legal, and accreditation/regulatory standards when communicating with all members of the claim.
• Authorizes treatment using the established criteria and performs manual bill review on assigned bills to ensure appropriate