Job Description

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
• Professional certification in Case Management (CCM, CRC, CRRN, COHN)  REQUIRED .
• Current CA RN license/CA practice experience/CA domicile OR recent CA domicile  REQUIRED.
• 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.
• 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.

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