Medical & Disability Nurse Case Manager

Overview

If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. Under general technical direction, you are responsible for medically managing an assigned caseload and, by applying clinical expertise, ensuring individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner.

Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. You also act as a clinical resource for field claim partners.

This is a remote position; however, you will be required to report into the office twice a month per business requirements if you reside within 50 miles of one of the following offices:
Lake Oswego, OR;
Chandler, AZ;
Hoffman Estates, IL;
Suwanee, GA;
Indianapolis, IN;
Plano, TX;
Boston, MA;
Westborough, MA;
Las Vegas, NV;
Weatogue, CT. Please note this policy is subject to change.

• Follows Liberty Mutual s established standards and protocols to effectively manage an assigned caseload of medical/disability cases and, by applying clinical expertise, assist to achieve optimal outcomes and to facilitate claim resolution and disposition.
• Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return-to-work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome.
• Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
• Appropriately utilizes internal and external resources and referrals (e.g., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation) to achieve the best possible case outcome.
• Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries.
• Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy.
• Applies clinical expertise to claims and delivers services in an efficient and effective manner.
• Documents time tracking for work performed and aims to achieve annual time tracking goals.
• Handles special projects as assigned.

• Ability to analyze and make sound nursing judgments and accurately document activities.
• Strong communication skills to build relationships with injured employees, medical professionals, employers, field claims staff and others.
• Good negotiation skills to effectively establish target return-to-work dates and coordinate medical care.
• Knowledge of state, local and federal laws related to health care delivery preferred.
• Personal computer knowledge and proficiency in general computer applications (e.g., Internet Explorer and Microsoft Office including Word, Excel and Outlook).
• Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing).
• Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience.
• Previous medical case management experience a plus.
• Must have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law.
• Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by workers  compensation law.

Pay Philosophy:
The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role…