[Hiring] Nurse Consultant Telephonic Case Management @Gallagher

Role Description

The Nurse Consultant - Telephonic will provide case management through telephonic contact with all medical providers, employers, claims professionals, and ancillary service providers.

• Provides medical management to workers compensation injured employees.
• Performs case management through telephonic contact with all medical providers, employers, claims professionals, and ancillary service providers.
• Manage medical care in order to return injured employee to pre-injury status.
• Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling.
• Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program.
• Evaluates home care services and equipment and determines need for home modifications.
• Coordinates home care.
• Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary.
• Analyzes results of treatment and medical status and reviews incoming provider reports.
• Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence.
• Generates reports to referral source to communicate case status, findings, and recommendations.
• Generates correspondence to referral source, medical providers, injured worker, and other parties involved in the rehabilitation process.
• Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency.
• Documents case management observations, assessment, and plan in system.
• Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected.

Qualifications

• Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required.
• Active Registered Nursing license or equivalent within the state of practice or states in which Case Management is performed.
• Bachelor's degree preferred.
• Worker's Compensation experience is preferred.
• Certification in related field preferred.

Requirements

• Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
• Demonstrates good written and oral communications, organizational and leadership skills.
• Computer literate.
• Demonstrates good time management skills. Self starter.

Benefits

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave
• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...