Specialty Nurse Case Manager

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Nurse Case Manager in a specialty area including but not limited to disability and psychiatry case management. Makes assessments and determinations applying various case and disability management principles within area of specialty. Ensures expeditious and effective claims decisions through collaboration with healthcare providers, employers, claimants and claims staff.

JOB DESCRIPTION :

Essential Duties & Responsibilities

• Performs a combination of duties in accordance with departmental guidelines :
• Assesses disability status, makes recommendations and identifies appropriate resources.
• Accountable for gathering and coordinating medical evidence for evaluation of functionality and makes assessments on restrictions and limitations and assigns length of disability.
• Consults on case management issues in area of specialty and applies effective case management interventions.
• Collaborates with medical and other providers to ensure appropriate treatment and return to work.
• Facilitates job modifications when appropriate and educates involved parties regarding claims process and functionality as it relates to job requirements while remaining externally focused.
• Addresses causality and refers to appropriate medical expertise.
• Documents according to jurisdictional, departmental and accreditation requirements.

Reporting Relationship

Typically Lead Specialty Nurse Case Manager

Skills, Knowledge And Abilities

Education and Experience

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