Telephonic Nurse Case Manager

 


RN CASE MANAGEMENT PROFESSIONALS


 


CLAIM YOUR FUTURE AS A GREAT PERFORMER!


 


What drives you in your search for a rewarding career?  Are you looking for an opportunity with an industry leader that offers individualized development for talented novices and advanced placements for knowledgeable veterans?


 


If you are an experienced Registered Nurse looking for personal growth and the opportunity to be part of an innovative, customer service oriented medical management team, look, no further!One of the premier dedicated accounts for Sedgwick CMS has an immediate opening in their Integrated Injury Management Unit for a proven medical management professional handling work injury claims.


 


Location:  Atlanta, GA


 


Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities.  We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. 


 


We are proud to have been recently voted the Best TPA in America, and we are a continuing Employer of Choice? award recipient, the first and only Third Party Administrator to receive this coveted designation.  Come be a part of our team and "Claim Your Future."



PRIMARY PURPOSE: To perform initial evaluation assessments and evaluate need for alternative treatment; to negotiate claims with providers and employers; and to provide case direction and supervision to field case specialists when on-site intervention is required ensuring quality and appropriate service delivery.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

Performs initial evaluation assessment via telephone calls to client, employer, and physician.
Evaluates need for alternative treatment.
Negotiates level of care, intensity and disability duration with providers
Negotiates and coordinates a prompt return to work with employer
Maintains accurate record of management including costs, savings and demographic data
Adheres to quality assurance standards
Provides case direction and supervision to field case specialists when on-site intervention is required; ensures quality and appropriate service delivery
Communicates effectively with handling claims examiner, client, claimant, and supervisor
Supports the Total Performance Management initiative

Education & Licensing:Baccalaureate degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred Active RN license required Certification in rehabilitation nursing or a related specialty is highly preferred Valid driver's license required

 

Experience: Two (2) years of clinical experience required

 

Skills & Knowledge:Knowledge of workers compensation laws and regulations Excellent oral and written communication skills, including presentation skills PC literate, including Microsoft Office products Leadership/management/motivational skills Effective analytical and interpretive skills Strong organizational skills Excellent interpersonal skills Persuasive negotiation skills Ability to work in a team environment Ability to meet or exceed Performance Competencies

Sedgwick CMS is an Equal Opportunity Employer