CCM/Field Case Managers - East and Gulf Coasts

Company:  Integrated Care Management 

Company Overview:  Our goal is to minimize employer expense while ensuring the proper level of care for the injured worker. We offer field case management, telephonic, on-site, catastrophic and vocational case management which can be employed individually or in combination based on the recommendation of our case managers, and in consultation with clients.

Position : CCM, Field Case Manager

Locations: We are looking for CCM, Field Case Managers is the following areas: North Carolina (Raleigh), South Carolina (Florence/Columbia), Texas (Dallas, Austin, El Paso- Bilingual in Spanish), Maryland, Pennsylvania, New York, Rhode Island, Virginia, Washing D.C. area, Connecticut, West Virginia, Ohio, Kentucky.

Date Available: Immediately

Contact Information: Please send all resumes to Lindsay Buser. LBuser@integratedcare.com  (678) 781-2830 Office (404) 441-4554 Cell 

Qualifications: CCM


Job Description

Basic Function
o    Provide medical case management services to various individuals, in various settings. These services include insuring communications, coordination of benefits at the onset of injury/illness.  These must occur on a timely basis; that patients will receive adequate and timely support to assure quality diagnoses and treatment plans; patient conformance with treatment plans; satisfactory rate of recovery; and, when applicable, return to work on undefined or accommodated duty as therapeutically indicated.
o    To interject objectivity and information where it may be lacking to maximize efficiency in utilization of available resources.
o    To allow multi-disciplinarians in various settings to work collaboratively during different phases of the person's illness, which maximizes the resources available.

Knowledge
o    Ability to communicate with patients, employers, medical professionals, carriers and supervisors.

o    Ability to form and maintain working relationships accounts, employers, patients  and community medical team.
o    Working knowledge of SSDI, rehabilitation, disability, medical and workers’ compensation benefits.
o    Formal knowledge of medical/rehabilitation as manifested by a degree (or acceptable equivalent) as a Rehabilitation Counselor and/or Registered Nurse, with at least one of the following: COHN, CRRN, CCM, CRC, CDMS. As well as two years of experience in Field Case Management. 
o    Ability to create and follow administration, communication and information systems, computer literacy.

Problem Solving

o    Correct clinical decisions within limits of training and experience. 
o    Ability to involve and correctly use clinicians judgments outside limits of training and experience.
o    Recognize deviations from adequate clinical quality and utilize resources to develop adequate plan for correcting quality.


Job Responsibilities:

Case Management Services:
Uses Clinical/nursing/case management skills to help coordinate the patients individual treatment plan while maximizing cost containment.

o    Serve as intermediary to interpret and educate the patient on his/her injury/disability, and the treatment plan established by physician. Explain Physician’s and Therapists instructions and answers any other questions the employee may have to facilitate his/her return to work .
o    Works with Physicians and Therapists to arrange medical assessments to develop an overall treatment plan to ensure cost containment, best medical care while meeting state and other regulatory guidelines.
o    Research and assess alternative treatment programs such as pain clinics, home healthcare, work hardening as well as coordinates with employer for possible Wellness Program.
o    Works with employers to identify and develop transitional / modified duty based on medical limitations and employees functional abilities. Assist in development of transitional work programs where able in effort to return employee to work.
o    May provide expert testimony on litigated cases.

o    Coordinates patients appointments and arranges transportation when necessary.
o    In the event that the employee is unable to return to work with modifications, case manager will coordinate the employee’s vocational rehabilitation to prepare them for reentry into the workplace as directed by account.

Administrative Duties:
Documenting and reporting all case activity is critical for accurate case management record keeping.
o    Maintain all case documents in Cambis ensuring comprehensive and detailed source of information for all parties to the claim.
o    Documents all case activity notes in Cambis for each phase of activity as it is completed.
o    Report to accounts as need based on each individual guideline. Minimum reporting is every 30 days.
o    Maintains e-mail and phone contact with all parties involved to monitor, update and advance case activity to ensure progress of the case.

Professionalism
Maintaining the necessary credentials and demonstrating a level of professionalism within the work place and in dealing with employees reflects positively on the company as a whole.

o    Maintains professionalism at all times despite the stressful demands of the position. Capable of maintaining close relationships among all parties involved, both in person and on the phone. Must be readily available for and responsive to clients and all other parties concerned.
o    Responds quickly and thoroughly to questions and concerns while maintaining confidentiality and safeguarding proprietary company information.
o    Acquires and maintains knowledge of developments in the medical case management field. Keeps abreast of local Worker’s Compensation laws and regulations, as well as other issues effecting the rehabilitation field. This is critically important for keeping licenses and certifications valid.
o    Willingly, with necessary and reasonable accommodation when applicable and essential to the job, performs all other duties requested in order to accommodate company operational needs.
o    Participation in professional associations keeps the case manager informed of events in their field, regulation changes as well as other issues affecting the rehabilitation field.