Clinical Case Manager (RN)

US-FL-Orlando | US
1 week ago(1/9/2018 3:07 PM)
Job ID
2018-1279
# of Openings
4
Category
Customer Service/Support

Overview

Who We Are: Reed Group is a dynamic, fast growing organization that works in a niche industry most commonly known as Third Party Administration. We are known for being a leader in managing absences for major companies including Fortune 100 companies. More specifically, instead of employers managing the process when an employee needs to go out on leave for FMLA (the family medical leave act) or for Short Term or Long Term Disability, we handle it for them. As a result we have a large customer operations team of talented individuals who manage our client’s employee cases.

We build the software (we have a large group of developers) to manage the entire work flow which is why you could easily think of us as a technology company. We also have a content business called MDGuidelines that contains treatment recommendations for best managing an employee back to work.

Right now we are over 1,900 employees (and growing daily).

 

The Reed Group Mission: We are about helping people get back to work. Often, this means helping people through difficult times in their lives. We help doctors do their best for their patients and we help employees protect their jobs. Our mission is: We believe there's a better way to help employers increase productivity, improve healthcare quality and help employees back to productive life.

Responsibilities

PURPOSE:   The Clinical Case Manager provides clinical oversight to medical disability and leave of absence claims. As the subject matter expert on these files, the registered nurse (RN) reviews claim decisions and is consulted on a variety of case management initiatives including medical disability durations, return to work obstacles and/or return to work planning and clinical guidance/education.

 

 

ESSENTIAL FUNCTIONS:

  • The Clinical Case Manager is a subject matter expert on illnesses and injuries. When applicable, they research pathology to gain necessary information applicable to the case management process.
  • The CCM has expertise in functional implications of illnesses/injuries as it relates to occupational requirements. They leverage this expertise by educating and guiding the case managers throughout the claim process.
  • The CCM has clinical knowledge to ascertain probable optimal recovery duration based on pathology, severity, treatment and its implication on occupational requirements.
  • Demonstrates adherence to Reed Group, Ltd. values and performance guidelines.
  • Manage production requirements, organize priorities, provide timely intervention and maintain sensitivity to confidential records.
  • Ensure quality standards for case management are met. Implement Reed Group’s continuous quality improvement process whenever efficiencies or quality standards are not met.

OTHER DUTIES:

  • Attend department and company meetings.
  • Provide support to peers as needed.
  • Other duties as required.

Qualifications

QUALIFICATIONS:

  • 5+ year’s clinical experience and a minimum of 3 years of case management experience in occupational health, workers’ compensation, or disability/absence management.
  • Registered Nurse with valid and current state nursing license (unrestricted)
  • COHN and/or CCM, preferred
  • Excellent interpersonal communication skills.
  • Advanced knowledge of medical documentation
  • Ability to type 50+ WPM
  • Intermediate to advanced level of computer experience.

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