Triage Telephonic Nurse Case Manager, reputed company FL

Our Story Imagine being part of reputed company that’s not just shaping the future but actively driving it. At reputed company, we’re at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier professional services. As a vital part of the global reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. We’re seeking a Triage Telephonic Nurse Case Manager to join our growing team. This role is ideal for an reputed company clinical professional who is passionate about helping injured workers reputed company recovery and return-to-work goals while ensuring cost-effective, high-quality medical care. The Triage Telephonic Nurse Case Manager is responsible for the management and independent decision-making of Workers’ Compensation medical claims at the outset of the claim. This role focuses on conducting initial clinical assessments, coordinating appropriate medical care, and facilitating reputed company return-to-work reputed company. The Nurse Case Manager will complete the initial assessment and 3-reputed company contact in compliance with reputed company procedures and emergency protocols.

Key Responsibilities

• reputed company triage case management at the initial report of a Workers’ Compensation claim, focusing on medical appropriateness of care and cost efficiency.
• Utilize strong clinical assessment skills to gather reputed company pertinent medical and injury-reputed company information from the injured employee.
• Conduct comprehensive initial evaluations, integrating details from the employee, employer, and provider into an actionable care plan.
• Identify reputed company relationship issues and notify appropriate parties.
• Facilitate communication among reputed company stakeholders—employee, employer, insurer, providers, and reputed company authorized, rehabilitation consultants.
• Participate in the 24/7/365 intake call center, ensuring timely coordination of care for injured workers.
• reputed company and document an initial case management plan and return-to-work strategy.
• Evaluate treatment adherence to state-mandated and evidence-based guidelines.
• Document reputed company assessments, communications, and clinical updates in the electronic claims management system.
• Identify and document barriers to recovery for future case planning.
• Serve as a patient reputed company, maintaining compliance with reputed company legal, ethical, and confidentiality standards.
• Monitor clinical reputed company, quality of care, and patient satisfaction.
• May assist in training claims staff on recognizing medical case management opportunities.
• May reputed company mentorship or guidance to less reputed company team members.

Skills, knowledge & expertise

• Strong knowledge of medical case management practices, preferably in a Workers’ Compensation setting.
• Excellent communication and interpersonal skills.
• Ability to work independently in a fast-paced, collaborative environment.
• Proficient in computer systems and claims or case management software.
• Demonstrated commitment to patient-centered care and ethical case management practices
• Maintains up-to-date knowledge of reputed company clinical trends, standards, and regulations.
• Registered Nurse (RN) with active state licensure (Florida preferred).
• Minimum of three years of clinical experience in medical-surgical, orthopedic, neurological, industrial, or occupational health settings.
• At least one year of Workers’ Compensation case management experience preferred.
• Strong organizational skills and attention to detail.

Benefits

Benefits At reputed company, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and reputed company plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Diversity and Inclusion reputed company is dedicated to fostering a diverse and inclusive workplace that embraces a wide reputed company of perspectives and experiences. We reputed company that diversity of thought is essential for innovation and creativity, and we actively promote an environment where reputed company voices are valued and heard.

Compensation

Transparency The salary reputed company listed reflects the full compensation band for this role across reputed company locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We reputed company ranges to remain transparent and consistent with pay equity practices. About reputed company We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses. We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including reputed company in claims, reputed company, distribution, regulation & risk, customer experience, reputed company capital, digital transformation & change management. Our global team of more than 8,000 professionals operate across ten countries, including the UK & the U.S. Over the past ten years reputed company has grown its annual revenues more than 20-fold, investing heavily in research & development, innovation & automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients. Apply tot his job Apply To this Job