Field Case Manager Remote Lexington, Morehead, Southeast KY

Charles Taylor North American Careers

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Position: Field Case Manager (Remote – Lexington, Morehead, Southeast KY)
Location: Remote
Job : 1192
# of Openings: 1

Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking an experienced Field Case Manager to join our Kentucky team. This is a remote position for candidates who live in the Lexington, Morehead, and Southeast KY areas.

The Field Case Manager position is responsible for assessing and analyzing information pertinent to injured employees to evaluate the medical and vocational needs required to facilitate the patient’s rehabilitation in order to promote appropriate and timely return to work. The right candidate will act as a liaison between patient/family, employer, provider(s), healthcare personnel, adjusters, and attorneys involved in workers compensation claims.

• Obtains medical history of the injured employee and a signed medical release form when appropriate for medical care coordination purposes
• Requests, obtains, and reviews medical records
• Assesses and analyzes an injured employee’s medical and vocational status
• Develops a plan of care to facilitate the patient’s appropriate and timely return to work; coordinates with the employer when appropriate
• Interviews patients in the physician office, home, work site, or telephone to provide ongoing case management services
• Communicates both in-person and telephonically with patients, medical providers, adjusters, attorneys, and vendors
• Schedules appointments for implementation and follow-up of treatment plan
• Coordinates and monitors progress and completion of vendor referrals, consultations, and therapeutic services for patients
• Ensures transportation and translation are available for the injured employee to attend medical appointments when appropriate
• Accompanies the injured employees during physician consultations when appropriate
• Conferences with specialists concerning course of care and treatment
• Ensures all injured employees’ and employers’ concerns are addressed by the physicians
• Ensures injured employees understand diagnosis of their injury/illness, and any instructions and recommendations regarding treatment when appropriate
• Provides consistent monitoring, contact, support, and education to injured employees to monitor patients’ progress toward desired outcomes, promote compliance, motivation, and address issues as they arise when appropriate
• With adjuster approval, coordinate necessary medical and rehabilitative care for injured employees including but not limited to appointments, medications, surgery, therapies, diagnostics, equipment, transportation, translation etc.
• Establishes effective rapport with all professions involved in the injured employees’ rehabilitation process to facilitate treatment, optimum care, and successful return to work
• Provides comprehensive documentation detailing case management services, the injured employees’ progress with treatment plan, return to work status, maximum medical improvement, and significant events that meets company standards for content and format
• When appropriate coordinate return to work issues with the employer, to include job site analysis, ergonomic evaluation, etc. and present to the physician for review
• Maintains a working knowledge of up to date medical information including but not limited to medications, procedures, equipment, therapies, treatments, their uses, contraindications, side effects, etc. and provides research information to adjusters to assist with determinations of medical necessity and appropriateness
• Applies all laws and regulations relative to the provision of case management and rehabilitation services in the geographic region assigned
• Testifies as required to substantiate any relevant case work or documentation
• Timely completion of time and expense reporting per company guidelines
• Works closely with team of case managers and support staff

• Degree in Nursing or other degree and appropriate experience as follows:
• RN with minimum of 3 years direct patient…