Sheakley
  • Cincinnati, OH, USA
  • Full Time

QUALIFICATIONS:

  • A current, unrestricted Ohio state licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline
  • Eligibility to hold a multi-state licenses as needed to meet the needs of the company
  • Two years full-time equivalent of direct clinical care to the consumer and
  • Prefer a minimum of one (1) year of active case management experience in worker's compensation
  • Maintains continuing education as required to maintain licensure and certification
  • Excellent leadership, verbal/written communication skills, strong organizational skills, and excellent decision making and judgment

 

ROLE AND RESPONSIBILITIES FOR THE CASE MANAGER:

 

  • Reports directly to The Case Management Team Lead
  • Serve as the first point of post-injury contact after triage, developing and managing return to work opportunities with injured workers, designated network providers, and employer contacts
  • Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis
  • Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion
  • Assess quality and clinical risk issues on a concurrent basis; report any recognized issue to the Case Management Team Lead
  • Assess documentation of medical records for completeness on a concurrent basis
  • Ability to obtain and interpret information appropriate to injured workers' needs as required for assessment, treatment, and patient care services
  • Assess, develop, implement and monitor plan of care;
  • Initiate communication and consistently communicate with the injured worker, employer, provider, BWC, and TPA (five-point contact, which could include attorney for IW/employer)
  • Provide education and guidance to all parties to the claim; this includes: claim review at staffings, and/or providing direction to any member of the five-point contact
  • Develop and maintain a positive work atmosphere and support overall team; demonstrate ability to work within a team structure
  • Practice capable and effective problem identification and resolution skills as a method of sound decision making
  • Maintain confidentiality
  • Work independently, efficiently, and deal with priorities
  • Understand and uphold UniComp philosophy and demonstrate commitment to UniComp's core values: have a sense of urgency, be optimistic, promote independence, and respect human dignity
  • Perform other duties as assigned
  • Practice nursing within the Scope of Practice as designated by the State of Ohio Board of Nursing
  • Employee may be asked to travel from time to time to attend employer meetings or other offsite functions.
Sheakley
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