RN Telephonic Nurse Case Manager – FL Workers’ Compensation

USIS, Inc.

Altamonte Springs, FL

Job Category: Other

Division: Services

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Job Summary

USIS, Inc., a subsidiary of Brown & Brown, Inc., is seeking an experienced RN Nurse Case Manager to monitor, evaluate and coordinate the delivery of high quality medical treatment and other health services under Workers’ Compensation law, as needed by an injured employee to promote an appropriate, prompt return-to-work when medically indicated.  Must have at least ONE year of Florida Workers’ Compensation or occupational case management experience.  Responsible for managing all care throughout a variety of services in order to achieve the highest level of quality medical care in the most cost effective and timely manner possible. Also responsible for performing ongoing assessments of the injured employee’s recovery to ensure high quality of care, reduce recovery time and minimize the effects of injury.  Opportunity to work from home for the right candidate.

 

 

 

 

 

 

 

 

 

 

 

Essential Duties:

 

  • Provide telephonic case-management in a Workers’ Compensation environment. Focus on medical appropriateness of care to injured worker with cost savings by coordination and utilization of all services, ensuring that as, soon as medically feasible, return-to-work status is achieved along with increase in productivity.
  • Facilitate communication between the employee, the employee representative, employer, employer representative, insurer, health care provider, the medical services organization and, when authorized, any qualified rehabilitation consultant to achieve the goals.
  • Clinically evaluate the recovery needs of an injured employee after the initial contact assessment. Incorporate into the initial plan information obtained from the employer and provider.
  • Manage the file adhering to treatment guidelines and utilization criteria as determined by the state-mandated guidelines, proprietary and nationally published protocols, as well as account requirements, assuring smooth delivery of services to injured workers or third party claimants.
  • Evaluate treatment plans and documents outcomes. Track protocol management for appropriate utilization and delivery of medical services. Outcomes will be evidenced by patient satisfaction, appropriate delivery and quality of care and timely recovery per evidenced based criteria and clinical guidelines. Return-to-work outcomes and length of disability outcomes are calculated and monitored according to criteria as published in the Official Disability Guidelines.
  • Serve as a patient advocate adhering to all legal, ethical and accreditation/regulatory standards.
  • Perform other duties as needed.

Required Skills

  • Registered Nurse RN with a minimum of 3 years clinical experience (orthopedic, neurological, neuromuscular, ICCU, industrial or occupational).
  • At least ONE year of Florida Workers’ Compensation or occupational Case Management experience required (per client contract).
  • Bi-lingual helpful (English/Spanish).
  • Must be able to work a diary system, keep the diaries current and document accordingly.
  • Must work productively and independently to accomplish goals of the job per caseload according to contractual performance standards.
  • Must be technically adept to utilize systems and software in an efficient and effective manner.
  • Excellent verbal and written communication skills. Good customer service skills and strong organizational skills.
  • Ability to work effectively in fast-paced environment, use own initiative, effectively multi-task and prioritize.
  • Positive and enthusiastic attitude, self-motivated professional.

 

Recertified 2020 – 2021 Great Place to Work®. Long-term company with excellent work environment, great people and wonderful team spirit.  Top notch benefits including medical, dental, STD, LTD, life, Employee Stock Purchase Plan, 401-k with company match, 5 weeks average Paid Time Off/year, floating holiday, regular holidays; eligible 1st of month after 30 days.

Salary Range

Competitive, based on experience.

Contact

Human Resources Department at [email protected]

We are an Equal Opportunity Employer. We take pride in the diversity of our team and seek diversity in our applicants.