Workers' Compensation Certified Nurse Case Manager
Oak Ridge, TN - USA
Job Summary
Location: Oak Ridge TN
Job Title: Workers Compensation Certified Nurse Case Manager
Career Level:Senior Specialist
Job Specialty: Workers Compensation Case Management
- Gather relevant information to assist in the investigation and evaluation of workers compensation claims through interviews verbal or written communications and medical records.
- Responsible for helping to ensure injured parties receive appropriate treatment directly related to their compensable injury.
- Attends medical appointments with injured employees.
- Communicates in person and by telephone with patients medical providers attorneys and insurance carrier to provide ongoing case management.
- Works collaboratively with claim handlers/adjusters to ensure that all injured parties are on an appropriate treatment plan and to manage medical treatment to resolution. Participate in periodic claim reviews.
- Work with others in a tactful congenial and professional manner so as to gain their trust and cooperation and accomplish assigned tasks.
- Exchange ideas information and opinions with others to jointly arrive at decisions conclusions solutions or otherwise solve disputes.
- Responsible for ongoing evaluation of treatment or return to work plan within established protocols.
- Interact with Occupational Health Services (OHS) and Environmental Safety &Health (ES&H) to obtain or clarify clinical information and participate in in-house case reviews.
- Maintain high standard of file documentation to ensure attention to detail and file accuracy and provide timely reports responses and case updates.
- Provide comprehensive medical case management oversight of workers compensation claims.
- Advocate for appropriate services and treatment to attain best practices standards maximum medical improvement and successful return-to-work.
- Communicate with employees line management Occupational Health Services (OHS) occupational safety and health administration (OSHA) recordkeeping benefits internal and external counsel external providers and others to ensure understanding of and cooperation with the recommended treatment plans and the goal of returning employees to meaningful work.
- Maintain required continuing education as outlined by CCM TN Bureau of Workers Compensation and CNS.
- Meaningful work and unique opportunities to support missions vital to national and global security
- Top-notch dedicated colleagues
- Generous pay and benefits with a stable organization
- Career advancement and professional development programs
- Work-life balance fostered through flexible work options and wellness initiatives
- Bachelors degree: Minimum 7 years of relevant experience as a workers compensation nurse case manager. Typical experience ranging from 10 to 15 years.
- RN with current state license required
- CCM certification required
- Knowledge of and working familiarity with the Official Disability Guidelines (ODG)
- Knowledge of and working familiarity with the MD Guidelines
- Documentation and calculation of cost savings per case
- Strong problem solving and analytical skills
- Excellent interpersonal oral and written communication skills
- Good computer skills including use of Word and Excel
- Ability to interface with treating physicians division managers OHS staff and employees
- Excellent organization skills
CNS is a drug-free workplace. Candidates accepting a job offer will be required to pass a pre-placement physical drug screening and background investigation. As an employee you may be required to receive and maintain a security clearance from the United States Department of Energy in order to meet eligibility requirements for access to sensitive information or matter. U.S. citizenship is a requirement for security clearance applicants. All employees are subject to being randomly selected for drug testing without advance notification.
CNS is an equal opportunity employer. All qualified applicants will receive consideration for employment based on merit and without regard to race color religion sex sexual orientation national origin protected veteran status or disability.
Required Experience:
Manager