[Hiring] RN Case Manager @The Sheakley Group Inc

Role Description

The Case Manager serves as the primary clinical contact for injured workers, coordinating care and facilitating safe, timely return-to-work outcomes. This role involves:

• Assessing treatment plans
• Collaborating with medical providers, employers, and insurers
• Ensuring quality, compliance, and effective communication across all parties

The Case Manager must exercise strong clinical judgment, organizational skills, and maintain confidentiality.

Qualifications

• A current, unrestricted Ohio state licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline
• Eligibility to hold multi-state licenses as needed to meet the needs of the company
• Two years full-time equivalent of direct clinical care to the consumer
• Prefer a minimum of one (1) year of active case management experience in worker's compensation
• Maintains continuing education as required to maintain licensure and certification
• Excellent leadership, verbal/written communication skills, strong organizational skills, and excellent decision making and judgment

Requirements

• Reports directly to The Case Management Team Lead
• Serve as the first point of post-injury contact after triage, developing and managing return to work opportunities with injured workers, designated network providers, and employer contacts
• Assess the appropriateness of the level of care, diagnostic tests, and clinical procedures for utilization review on a concurrent basis
• Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion
• Assess quality and clinical risk issues on a concurrent basis; report any recognized issue to the Case Management Team Lead
• Assess documentation of medical records for completeness on a concurrent basis
• Ability to obtain and interpret information appropriate to injured workers' needs as required for assessment, treatment, and patient care services
• Assess, develop, implement and monitor plan of care
• Initiate communication and consistently communicate with the injured worker, employer, provider, BWC, and TPA (five-point contact, which could include attorney for IW/employer)
• Provide education and guidance to all parties to the claim; this includes: claim review at staffings, and/or providing direction to any member of the five-point contact
• Develop and maintain a positive work atmosphere and support overall team; demonstrate ability to work within a team structure
• Practice capable and effective problem identification and resolution skills as a method of sound decision making
• Maintain confidentiality
• Work independently, efficiently, and deal with priorities
• Understand and uphold UniComp philosophy and demonstrate commitment to UniComp's core values: have a sense of urgency, be optimistic, promote independence, and respect human dignity
• Perform other duties as assigned
• Practice nursing within the Scope of Practice as designated by the State of Ohio Board of Nursing
• Employee may be asked to travel from time to time to attend employer meetings or other offsite functions