Nurse Case Manager Job Washington area,District of Columbia USA,Nursing

The salary range for this job posting is $55,132.00 - $ annually + bonus + benefits.

Pay Type:

Salary

The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process.

While we prefer candidates who reside in Pennsylvania, we will consider those who live in any of our listed payroll approved states. We may hire a senior level and the posted salary range is inclusive of both levels. Nurse licensures in multi-states is a plus.

The actual salary range for candidates who reside in Pennsylvania is $59,630 to $119,670 annually + bonus + benefits.

Pay Type:

Salary

The position reports to the Director, Workers' Compensation Claims.

Are you a Referral?

If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our Talent Acquisition Team.

Unique residence requirements are listed in each job posting, please review closely for details.

Encova is only able to employ associates who reside and work within specific U.S. states. Our current policies are based on the laws in states in which we are registered for payroll. Our current footprint includes:

Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin.

Job Objective

The Nurse Case Manager serves as an office-based skilled medical resource for the business teams. The position’s objective is to provide high quality customer service in medical case management and utilization review, primarily telephonically. The Nurse Case Manager provides medical expertise and serves a critical role in the cost containment of medical and indemnity expenses.

Essential Functions

Complete early medical management assessment and intervention on claims requiring medical treatment. Contact injured workers and medical providers to obtain necessary information.

Apply knowledge, experience and evidence-based guidelines to evaluate claims and provide a proactive action plan.

Perform essential medical case management activities assessment, planning, implementation, monitoring and evaluation within accepted treatment guidelines.

Address medical cost containment through utilization management, collaboration with providers and assessing network resources.

Partner with appropriate team members to expedite injured worker recovery and return to work and to reduce disability costs.

Identify and monitor claims for task assignments to field case managers.

Evaluate accuracy of diagnoses of injuries or disabilities.

Document recommendations, contacts, actions and outcomes.

Adhere to jurisdictional regulations and standards.

Provide high quality customer service within a team-based environment.

Other Functions

Non-essential function: other duties as assigned.

Knowledge,

Skills and Abilities

Licensed Registered Nurse with no restrictions.
Minimum of an Associate degree in nursing from an accredited college or university or successful completion of a diploma nursing program required. Bachelor’s or Master’s degree in nursing preferred.
One year of experience in nurse case management, medical case management, utilization review, vocational/disability case management required.
Nationally recognized specialty certification in occupational or rehabilitative nursing or case management must be obtained as applicable, such as Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Certified Registered Rehabilitation Nurse (CRRN), or Certified Occupational Health Nurse (COHN). National certification may substitute for one year of experience…


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