In this role, you will be responsible for authorize and coordinate required services in accordance with the benefit plan and works collaboratively with the utilization management department for prior authorization requirements.
As a Case Manager in our Lisle, IL office, you will telephonically actively engaging consumers to develop the right care plan ensuring the member has the right providers, medications, right care and is optimally self-managing their lifestyle.
In this role, you will develop a progressive plan of care to facilitate medical recovery and progressive return to work. He / She will collaborate with members of the health care team to provide ongoing case management services.
In this role, you will be responsible for assessing, monitoring, implementing and evaluating care and services for patients to ensure their healthcare needs are addressed across the care continuum. Utilizes evidence-based resources to guide and improve appropriateness of case strategies.
The selected candidate will prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records, and confers with other health care disciplines in providing optimum patient care.
In this position, you will acts as liaison for involved parties in the worker's compensation injury by communicating in person and telephonically with the patient/caregiver, attorneys, employer, claims examiners, telephonic nurse case manager, return to work specialists, vocational rehabilitation supervisor, provider(s), ancillary provider(s) and health care team.
As a RN Case Manager, your ability to manage client care with specific knowledge and experience in bedside care, symptom management, crisis intervention and family intervention are feature assets for this high-profile nursing position.