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Job Requirements of Nursing - Case Manager:
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Employment Type:
Contractor
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Location:
Hopewell, NJ (Onsite)
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Nursing - Case Manager
Careers Integrated Resources Inc
Hopewell, NJ (Onsite)
Contractor
Job Title: Nursing - Case Manager
Job Location: Hopewell, NJ
Job Duration: 6 Months (possibility of extension)
Payrate: $30 - $33/ hr on w2
Job Summary:
Job Location: Hopewell, NJ
Job Duration: 6 Months (possibility of extension)
Payrate: $30 - $33/ hr on w2
Job Summary:
- Provides telephonic case management for workers compensation cases involving lost time and extensive medical care.
- Acts as a liaison between claimants, providers, external claim representatives, clients and attorneys, as needed, to manage the appropriate level of care.
- Performs selected medical appropriateness protocol procedure activities including telephone interviews and collection of information from claimants, providers and the client.
- Performs three-point contact, directs care into the network, follows up on status of treatment, corresponds with providers and documents the file consistently.
- Evaluates and coordinates the treatment plans proposed by providers, in accordance with established client protocols.
- Authorizes medical treatment and associated diagnostic testing on assigned claims.
- Acts as liaison with client to identify issues and problems relating to medical care, treatment plans, and claim processing and forwards concerns to appropriate parties, when necessary.
- Initiates calls and correspondence to claimants, providers, and the client to coordinate courses of treatment.
- Reviews and identifies claims involving complex injuries/treatment plans and refers them to a nurse case manager.
- Prefers a bachelors degree.
- Requires a minimum of two years business experience, preferably in a medical support related position or health insurance environment.
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications.
- Requires knowledge of medical terminology.
- Prefers knowledge of understanding of case management, philosophy and process.
- Strong typing, data entry and numeric keypad skills necessary.
- Must be comfortable using a calculator for simple math calculations.
- Analytical and Problem Solving Skills, Customer Focus, Interpersonal and Client Relationship Skills, Communication (both verbal and written) and Organizational Skills, Decision Making, Flexibility/Adaptability.
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