Summary:
To provide telephonic case management services to short term disability recipients by assessing, planning, facilitating and advocating the health needs. Perform UR reviews on worker’s compensation cases. Special projects as assigned.

Responsibilities:
• Assessment of the individual’s personal and medical history, current status, prognosis, current treatment plans and care provider's level of expertise.
• Determines appropriateness of care, quality of care, and timeliness of testing.
• Recognizes medical and non-medical issues, which may adversely impact employee recovery.
• Communicates with the treating provider regarding indications for potential treatment and diagnostic studies.
• Serves as a liaison with the Occupational Health staff and treating provider staff to facilitate maximum benefit and promote recovery.
• Ongoing promotion and maintenance of quality assurance standards from a Case Review/Case Management standpoint, as well as in the provision of customer service.
• Identifies any temporary or permanent alterations in function.
• Identifies potential challenges or complications in physiological and/or psychosocial function.
• Ensures that all documentation is current, timely, grammatically correct, consistent and appropriately reflects the sense of circumstances of the case.  Documentation must also adhere to company practices.
• Participates in ongoing training meetings and inservices.
• Other duties as assigned.

Qualifications:
• Ability to work independently, as well as cooperatively with others.
• Experience dealing with multiple tasks, and problem solving under pressure.
• Exposure to and familiarity with computer systems desired.
• Strong interpersonal skills, including oral and written communications.

Experience:
• Registered Nurse, Current MA State Licensure, CCM preferred.
• Minimum 3-5 years of acute clinical experience preferred
• Must have strong background, consisting of three or more years experience in injury management.

MCMC is a provider of managed care services including independent peer review, independent medical exams, medical bill review, telephone case management, first report of injury and hospital bill audits to assist our clients in managing their group health, workers’ compensation, disability, auto and general liability claims. At MCMC, we have built our business around referral-based services, providing these services to many of the nation’s largest insurers, as well as TPAs, PBMs, self-insured employers, labor unions, law firms, and state funds.

Our flexibility and ease of use ensures that we fulfill our commitment to our clients by being a partner who provides a quality and timely service, which is competitively priced, whether to a large national organization or a small regional client. By continually providing superior services, we have become an industry leader. www.mcmcllc.com

Please send Resumes to:
Attn: Human Resources
MCMC LLC
88 Black Falcon Ave. Suite 353
Boston, MA 02210
Fax: 617-375-7690
Email: MA.HR@mcmcllc.com
EOE