Clinical Nurse Utilization Mngr: Stratacare

Job Summary

As a Clinical Services Manager – RN Telephonic Case Management, you will ensure optimum recovery on every claim while establishing trust, providing education, delivering information, and care. You will provide case direction to field case managers when on-site intervention is required.

Primary Duties & Responsibilities
• Performing within the professional practice guidelines set forth by the state Board of Nursing & Division of Workers’ Compensation.
• Collaborating with clients and business partners to ensure quality standards are maintained for all accounts.
• Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
• Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.
• Interview injured persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.
• Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.
• Work with employers and physicians to modify job duties where practical to facilitate early return to work.
• Evaluate and modify case goals based on injured/disabled persons’ improvement and treatment effectiveness.
• Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.

Qualifications
• Bilingual in English and Spanish REQUIRED
• Current CA RN license/CA practice experience/CA domicile OR recent CA domicile
• Associates Degree or Bachelor’s Degree in nursing or related field. Active Registered Nurse (RN) license required. Must be in good standing.
• 2+ years clinical practice preferred. Workers’ compensation-related experience preferred.
• Professional certification in Case Management (CCM, CRC, CRRN, COHN), Disability Management (CDMS), or Qualified Rehabilitation Provider (QRP) preferred.
• Have the ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.
• Show organizational and planning skills.

Working Conditions & Physical Requirements
• The work environment characteristics described here is representative of those of a standard office setting. The noise level in the work environment is usually moderate.
• While performing the duties of this job, the employee must be able to remain in a stationary position over 50% of the work day; move about inside the office to access files or office equipment; use hands to finger, handle, or feel objects, tools, or controls to operate a computer and other office productivity machines; reach with hands and arms; must communicate and converse with co-workers; and detect/discern information accurately. Specific vision abilities required by this job include close vision and the ability to adjust focus. The employee must occasionally lift and/or move up to 10 pounds.

What We Offer
• Possibility for remote and hybrid work opportunities
• Great work-life balance
• Medical, Dental and Vision insurance
• Company paid Life & Disability Insurance
• Flexible Spending Accounts
• 401(k) with employer contribution
• Generous Paid Time-Off policies
• Employee Assistance Program
• Referral Program

Disclaimer

The aforementioned statements are intended to describe the general nature and level of work to be performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of an incumbent.
• Current CA RN license/CA practice experience/CA domicile OR recent CA domicile
• Current CA RN license/CA practice experience/CA domicile OR recent CA domicile

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