Medical Case Manager III

Downers Grove, IL 60516
Full-time

job closed

company

This company helps diverse clients manage insurance claims, coordinate return-to-work policies, prevent and control potential loss, and ensure best outcomes for injured workers. This TPA offers a wholly owned and fully integrated suite of managed care tools and services. This means that they bring a single, powerful solution to workers’ compensation claims to deliver the best outcomes for injured workers and our clients. Their claims adjusters and on-staff clinical experts work hand-in-hand to facilitate quality care and superior results. Defining quality is simple: prevent an illness or injury from becoming a permanent disability that diminishes a person’s productivity or quality of life and return the employee to work healthy, quickly and in the most cost-effective manner for the employer . Broad customer base includes more than 5,800 public entities and public entity pools; more than 300 program administrators/MGAs/carriers; more than 50 insurance carriers and more than 500 self-insured/high deductible clients.

overview

Top reasons to love this job – 1. Forbes list of America’s Best Midsized Employers 2. The 3rd largest independent TPA in the industry 3. Competitive benefit package 4. Great work life balance 5. A supportive team and management group who is dedicated to developing and mentoring their staff, preparing career paths and resources for success. Top "must-have" skills for this job – 1. Three or more year’s workers compensation case management experience or related field 2. MA/ BS / BA in Nursing or Associates Degree in Nursing from accredited school with Equivalent Work Experience and a CCM, CIRS, CRRN, COHN or other related designation or; BA/BS or MA in related field with a CCM, CDMS, or CRC or other related designation or; Current Nursing license and/or certification 3. CCM required based on state guidelines. Tell me about this job – The Medical Case Manager provides medical and vocational assistance and coordination services to assist injured workers in reaching maximum medical improvement and return to work. The Medical Case Manager facilitates communication between all parties including the injured worker, the adjuster, the employer, treating physician(s) and ancillary providers to assist the injured worker in obtaining prompt and appropriate medical treatment. The Medical Case Manager assesses rehabilitation needs and makes appropriate recommendations. The ultimate goal is for the injured worker to recover and return to work as soon as is medically appropriate. The Medical Case Manager facilitates any temporary or permanent job modifications necessary to allow the injured worker to return to work within the applicable physical restrictions assigned by the doctor. The exact role the Medical Case Manager plays will vary with the injury management model used by each customer.