Telephonic Medical Case Manager
Telephonic Medical Case Manager
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Job Description
The Claims Operations department has an immediate opening for someone who can demonstrate the WCF values to join their team as a Telephonic Medical Case Manager. This is a full-time exempt hybrid position that works out of WCFs Sandy Utah headquarters. This posting is open to internal and external candidates.
Responsibilities
- Assess plan implement coordinate and monitor medical services for injured workers.
- Communicate with injured workers providers adjusters and other contacts to coordinate all medically approved services.
- Analyze medical records and clinical criteria to determine appropriate treatment and case direction.
- Serve as a medical resource to claims adjusters vocational rehabilitation counselors legal department and other WCF employees.
- Obtain accurate information and document the medical rehabilitation plan progress and recovery.
- Identify and recommend referrals to Field Case Management when appropriate.
- Demonstrate self-direction accountability critical thinking analytical and research skills.
- Adhere to Utah Labor Commission rules and standards.
- Remain objective and professional when balancing conflicting needs of injured workers providers and claims adjusters.
- Provide excellent customer service and maintain diplomacy and confidentiality in all professional working relationships with internal and external customers.
- Maintain RN licensure certifications and continue to enhance learning of industrial injuries.
Qualifications
- Graduate of an accredited RN program and current Utah license.
- Minimum of three years clinical experience or equivalent combinations of education and experience required (ICU critical care rehab orthopedics home health or occupational health).
- Experience in discharge planning quality assurance or case management preferred.
- Knowledge of workers compensation claims and medical recovery process.
- Strong communication (verbal and written) time management computer and negotiation skills.
- Efficient multi-tasking and clinical prioritization.
WCF Insurance offers an extensive compensation package. Benefits include Medical Dental and Vision insurance company paid life insurance 401K with a generous 6% employer match and additional benefits such as an Employee Assistance Program (EAP) and time off to volunteer in the local community. All employees earn 4 weeks of vacation in their first year. Expected salary for this position is $78000 - $98000 depending on experience and education.
Internal candidates should have acceptable job performance 6 months in their current position and must notify their current supervisor that they have applied for the position.
Our People
WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive
WCF Insurance is an Equal Opportunity Employer
WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race color religion sex age national origin veteran status disability that can be reasonably accommodated or any other basis prohibited by federal state or local law.
Required Experience:
Manager
Employment Type
Full-Time
