Telecommute Nursing Jobs – Telephonic Workers Compensation Nurse Case Manager

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Liberty Mutual Insurance: Telephonic Workers Compensation Nurse Case Manager

Job Description

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, responsible for medically managing an assigned caseload and applying clinical expertise to ensure individuals receive appropriate healthcare to return to work and normal activity in a timely and cost-effective manner. The caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical-only claims. Also, act as a clinical resource for field claim partners.

Liberty Mutual offers flexible work arrangements to help employees balance their days. If you choose to work from home, you may be asked to come into an office for collaborative activities with your team, as needed.

The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region.

California or Compact RN license required. Somewhat flexible in location as long as the selected candidate can work Pacific Time Zone hours.

Responsibilities:

• Follows Liberty Mutual’s established standards and protocols to effectively manage an assigned caseload of medical/disability cases and by applying clinical expertise assist in achieving the optimal outcome and 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 i.e., 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.
• Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner.
  Accurately and appropriately documents billable time for work performed. Achieves annual chargeable time goal.
• Handles special projects as assigned.
• May conduct in-person visits on assigned cases with injured employees, medical professionals, and the employer to assess medical recovery, physical capabilities, RTW barriers, physical job requirements, and modified duty opportunities.
• The Internet must support company programs from a virtual home office.

Qualifications

• Ability to analyze and make sound nursing judgments and to accurately document activities.
• Strong communication skills in order 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 is preferred.
• Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel, and Outlook).
• A degree from an accredited nursing school is required (preferably a 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 is a plus.
• Must also have a 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 WC law.
• At Liberty Mutual, our purpose is to help people embrace today and confidently pursue tomorrow. That’s why we provide an environment focused on openness, inclusion, trust, and respect. Here, you’ll discover our expansive range of roles and a workplace where we aim to help turn your passion into a rewarding profession.

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