Medical Case Manager
Medical Case Manager
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$ 79500 - 99300
1 Vacancy
Job Description
This posting is scheduled to close on March 20 2025 at 11:59pm. If a sufficient number of qualified applications are received this posting may close early.
Apply today!
About the job:
At Montana State Fund we partner with employers and their employees to care for those injured on the job. The Medical Case Manager provides not only medical expertise and analysis but helps injured employees return to work and receive quality treatment plans and approaches. Our Medical Case Managers partner with internal business partners injured employees and medical providers to ensure our employers and employees receive the care and support they need.
Medical Case Managers provide expertise and medical case management for medically complex workers compensation claims. They partner with internal business partners and injured workers to support resolving medical issues and questions effectively and efficiently.
Are you an experienced RN who is looking to make a difference for Montanans while enjoying a hybrid work environment Apply today!
Required Skills
What you will do:
- Medical case management and expertise: Provide medical expertise to claim examiners and injured workers relating to diagnosis treatment plan and related expenses. May facilitate identifying and obtaining appropriate care as medically needed. Work with business partners to bring medical issues to an expedient and effective resolution. Interviews the injured employee and collaborates with other team members to facilitate and identify appropriate medical care. Provide medical expertise relating diagnosis treatment plan and medical expenses to reported injury/occupational disease.
- Medical analysis and research: Research analyze and provide treatment plans with evidencebased best practices. Analyze medical claims management with other claims professionals through communication coordination and facilitation of information to assist with returntowork efforts and negotiate appropriate treatment plans with medical providers. Conducts file reviews for early intervention of claims focusing on medical provider records.
- Business partner collaboration communication and consultation: Effective communications with injured employees medical providers and business partners. Provide education consultation and assist with returntowork efforts. Assist team members with bringing medical issues to an expedient and costeffective resolution. Assist the Claims Examiner with authorization requests utilizing medical records and Montana Utilization and Treatment Guidelines. Attend strategic staffings large loss litigation mediation DOM care or large purchase meetings to provide insight and expertise. Develop and support learning within the department and organization
Required Experience
What you will need (minimum qualifications):
Required:
- Must have a current RN licensure
- AND a minimum of four 4 years clinical experience AND experience in medical case management
- OR an equivalent combination of education and experience.
Preferred:
- BSN Licensure
- Case management experience in workers compensation
- Related certifications: Certified Case Manager Certified Rehabilitation Registered Nurse Certified Occupational Health Nurse Certification in Case Management Community Health Certified Managed Care Nurse Home Health or MedicalSurgical Nursing
Job location: This is a hybrid position available within the State of Montana. Routine travel to the Helena MT office may be required as needed. Candidates must live within the State of Montana to be eligible for the position.
Compensation and Benefits:
- Pay range 3B: Starting salary for the position begins at $79500$99300. The maximum pay is $119200 per year. This is an exempt position.
- Montana State Fund offers excellent benefits paid time off and a competitive compensation program including:
- Excellent health insurance with dental vision life longterm disability and more with optional dependent coverage.
- Flexible spending accounts for dependent care and medical expenses.
- Public employees retirement plan taxdeferred contributions with a generous employer match.
- Optional 457(b) deferred compensation to further increase retirement savings.
- Higher education reimbursement and other training and development programs.
- Robust personal leave paid holidays and extended leave.
Required Experience:
Manager
Employment Type
Full-Time
