Company Overview: VRS Disability Management is a New England based company focusing primarily on Workers’ Compensation. We perform a wide variety of services, such as Vocational Rehabilitation, Nurse Case Management, Fee Negotiations, and Hospital/Provider Audits.
Position Overview: The Customer-Dedicated Medical Case Manager (CMCM) is a VRS employee working on behalf of a specific customer. The CMCM is a healthcare professional who possesses comprehensive knowledge of medical case management principles and applies that expertise to provide case management services to our specific customer’s adjusters and their injured workers (IW). This is a hybrid position, combining predominantly telephonic case management with some field case management and occasional onsite office work. The CMCM serves as a critical liaison among IWs, healthcare providers, adjusters, and other stakeholders involved in a workers’ compensation claim. The CMCM enhances the quality and timeliness of medical treatment rendered to IWs, promotes cost-effective healthcare solutions, and ensures that IWs receive optimal care and support to achieve the best possible recovery and return-to-work outcomes The CMCM must establish and maintain cooperative, professional relationships with the individuals in each case, while delivering exceptional service through responsive communication, empathy, professionalism, and a commitment to meeting the needs of the customer, its adjusters, and injured workers. The CMCM is expected to provide a positive customer experience by fostering trust, resolving concerns effectively, and ensuring all stakeholders receive timely and accurate information throughout the life of the case.
Workplace Environment: The CMCM works primarily from a home office and utilizes a computer, telephone, and fax/scanner to collect, analyze, process, receive, and transmit case-related information. VRS provides the technology and equipment necessary for appropriate home office set up. The CMCM is responsible for ensuring that all files, records, correspondence, and all other case-related documents are maintained in compliance with HIPAA and security requirements.
In addition to remote work, the CMCM may at times be required to perform field-based case management activities, including attending physician appointments and meetings with other healthcare providers as needed to support injured workers and facilitate recovery and case resolution. The CMCM may also be required to work onsite at the customer’s office on a weekly, monthly, or as-needed basis, depending on operational and customer needs.
Because the position may occasionally involve travel, the CMCM must be able to travel safely and effectively under varying weather and road conditions. Occasional travel during inclement weather may be required; however, the CMCM is expected to exercise sound professional judgment and prioritize personal safety when determining whether travel conditions are appropriate.
Main Tasks and Responsibilities:
· Develop and maintain positive and productive relationships with injured workers, medical providers, adjusters, and other stakeholders in order to effectively manage cases.
· Communicate with injured workers, medical providers, adjusters, and other relevant parties to coordinate care that is appropriate, timely, and effective for the injured worker.
· Review case progress to identify barriers to medical recovery and return-to-work and develop effective strategies to overcome these.
· Educate injured workers regarding treatment so that they are able to make informed decisions about their plan of care.
· Work with adjusters to determine availability of modified duty and promote early return-to-work.
· May attend medical provider visits, such as physician, physical therapy, occupational therapy, etc., to assess IW status, treatment plan, and progress toward recovery.
· Document case status and progress via notes entered into an adjuster’s online platform such as Origami.
· Document all case-related contacts (calls, emails, visits, etc.) in the adjuster’s online platform.
· Adhere to professional standards as outlined by state rules and regulations, as well as VRS policies.
· Ensure a home-based office is a private and professional location from which to work
Skills & Qualifications
· Licensed as an RN
· Experience with orthopedic, neurological, and soft tissue injuries
· Effective communication skills
· Excellent organizational and time-management skills
· Familiarity with emerging professional and technical research and knowledge
· Excellent multi-tasking and problem-solving skills
· Working knowledge of Microsoft Office and email
· Valid driver’s license and excellent driving record
Personal Attributes
· Honest
· Flexible
· Respectful
· Accountable
· Team player
· Desire to learn and grow
Physical Demands
· Lifting a maximum of 10-15 pounds
· Frequent sitting
· Occasional walking
· Occasional standing
· Frequent fine finger manipulation - typing
· Occasional driving
Pay: $41.47 - $47.48 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- License reimbursement
- Life insurance
- Mileage reimbursement
- Paid sick time
- Paid time off
Application Question(s):
- Are you located in New Hampshire?
- Do you have a minimum of three years' clinical experience as a nurse?
License/Certification:
- New Hampshire RN license (Preferred)
Work Location: Hybrid remote in Concord, NH 03301
