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Telephonic Nurse Case Manager

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Job Description - Telephonic Nurse Case Manager

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.

Job Description

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team.

Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to:

  • Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the claimant’s health across the care continuum.
  • Coordinate care delivery and support among claimant support systems, including providers, community-based agencies, and family.
  • Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability.
  • Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services.
  • Prepare and deliver trainings to claims staff via a variety of modalities including written materials, live presentations, WebEx and/or telephonic presentations.
  • Identify opportunities, develop, and implement new clinical programs as well as improve existing programs and procedures.
  • Assist in developing and maintaining vendor and consultant expectations and relationships.
  • Negotiate rates with local healthcare providers including nursing homes, sub-acute facilities, and attendant care agencies.
  • Assist with other duties in the clinical team department, or elsewhere, on request. 

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Desired Skills & Experience

  • Active RN license in good standing required, BSN highly preferred. 
  • Certification in Case Management (CCM) required or to be obtained within 18 months of hire.
  • Insurance Rehabilitation Specialist (CIRS), Disability Management Specialist (CDMS), Rehabilitation Nurse (CRRN), or Occupational Health Nurse (COHN) a plus.
  • Minimum of three to five years clinical experience required.  Strong clinical background in orthopedics, neurology, rehabilitation or trauma care is preferred.  Insurance experience a plus.
  • Minimum of three years experience as a case manager.
  • Ability to communicate effectively in oral and written forms, read and interpret documents, and write routine reports and correspondence. Proficient computer skills including Microsoft Office products.  Teaching or training experience a plus.
  • Excellent problem resolution skills. This person should be able analyze details, make decisions, demonstrate innovativeness and continually seek more efficient ways to process and handle work for the benefit of the team.
  • Excellent organizational skills with the ability to manage multiple priorities.

Benefits

Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!

*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.

#LI-AT1   #LI-Hybrid

Original job Telephonic Nurse Case Manager posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.
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