Senior Manager - INS018418
Responsibilities • Evaluate Short Term Disability claims from a medical perspective to determine a claimant’s functional abilities. This involves taking a balanced perspective of the claimant’s statements, exam notes, treating provider’s opinion, diagnostic test results, and treatment plan, in order to determine limitations and restrictions that may impact a claimant’s ability to work. • Communicate this evaluation to claims handlers by writing case notes that clearly describe your evaluation and summarize the facts that you used to make your evaluation. • Work within a computer application (Claim Vantage) to access claim information and make your evaluation. Qualifications • Excellent product/process understanding – features, benefit, procedure and guidelines • Computer skills – MS office functions • Excellent communication skills – comprehension, articulation, effective listening and written Minimum qualifications Our ideal candidate will: • Candidates should be – Band 4A • Have at least 1 year of experience working as a Nurse Case Manager in the disability field (insurance/healthcare). • Have qualified experience in a field such as neurology, neurosurgery, orthopedics, cardiology, pulmonology, nephrology, rheumatology, or oncology. • Be able to resolve conflict if a difference of opinion arises. Job Specifications: • Education: Bachelor’s degree or higher in Nursing, though an associate degree can be acceptable if all other qualifications are met. • Experience: Minimum 1 year hospital or clinical experience in relevant medical fields • Professional Certification: Active RN license in US Preferred qualifications • Have critical thinking skills, as exemplified by the ability to review medical information and make conclusions regarding an individual’s functional capacity, duration of impairment, and recommendations for next steps when appropriate. • Have a breadth of experience with a wide range of medical conditions while also demonstrating a history of working in settings that show a depth of knowledge in at least one specific field. • Have an ability to communicate clearly and effectively in English by oral and written means. An ability to collaborate with individuals with or without a medical background is needed. • Be able to take feedback, be proactive, and make meaningful change as needed. • Have basic office skills, including the ability to use a computer for email and basic Microsoft Office applications. • Have exceptional customer service skills, excellent organizational skills, adaptability, and the ability to multi-task and prioritize
Master Skills List Operations
Job Category Full Time
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