Field Case Manager (Tcm)

Position Overview

To perform Field Case Management for workers' compensation claims based on review criteria and protocols in accordance with state and regulatory agency compliance. This is a position that requires critical thinking and problem-solving skills with effective written and verbal communication skills. The environment is fast-paced and ever-changing.

Roles And Responsibilities

• Maintains confidentiality and security in all aspects of performance.
• Adhere to all deadlines and state statutes.
• Communicates timely with client, both verbally and written, according to Ethos policies and procedures
• Documents clinical criteria utilized in case analysis and medical case management.
• Assists in promoting and furthering the objectives of the Medical Management Division.
• Performs other related duties incidental to the work described herein.
• Provides field case management, to include patient contact, data analysis and ongoing communication with the injured worker's providers.

Qualifications

• Valid Texas RN License required - (Compact Endorsement - preferred)
• Certified Case Manager (CCM) or Certified Disability Management Specialist (CDMS) required.

Experience

• Prior experience in a managed care or workers' compensation environment preferred.
• English/Spanish bilingual preferred.

Skills/Knowledge

• Computer knowledge required, including Microsoft Office products.
• Able to perform as part of a team.
• Discretion and confidentiality.
• Strong ability to review medical records and identify critical details impacting medical treatments and medical necessity determinations.
• Strong organizational skills and excellent people skills.
• Excellent customer service skills.
• Strong oral and written communication skills.
• Must be initiative-taking, independent, and accountable. Strength in multi-tasking and clinical prioritization required.

Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic protected by law.

Job Posted by ApplicantPro