Job Description
Description:
The Telephonic Triage Nurse Case Manager is a Registered Nurse and may also be referenced as the TN.
The TN implements integrated medical disability case management services with the goal of preventing, minimizing, or overcoming disability.
The TN provides medical expertise and serves as the critical communication link between the parties involved in any medical disability case.
The TN emphasizes returning medically able individuals to productive service and facilitating early access to appropriate care.
The TN ensures timely interventions as outlined by the Nurse Vocational Rehabilitation Services (NVRS) contract with the Department of Labor (DOL) and facilitates continuous communication while providing patient advocacy through supporting patient choices.
Utilizes direct communication and proactive problem-solving to address challenges and disagreements.
The TN CM assignment is determined by DOL with a maximum assignment duration of two weeks.
The TN is sensitive to the importance of productive work and sees a return to work as the key outcome.
Accepts assignments based on referrals from DOL with service period limitations
Responsible for coordinating timely contact and information sharing with the injured worker, treating provider, and Agency.
Accurate, timely, documentation of contact attempts and communications in assigned case management systems as identified by SGS as well as DOL
Conduct and document an assessment of each injured worker/employee including (as appropriate) regarding clinical and non-medical obstacles. sychosocial status, consumer knowledge, education needs in relation to health status and treatment plan, past relevant history, and possible non-medical impediments to successful resolution
Collaborate and clearly communicate with the injured worker/employee, providers, employer, or the employer's representative in the execution of a plan for return to work or other productive activity.
Identify and obtain any required or outstanding medical documentation in support of the individual's plan for a return to work or other productive activity.
Understand and implement criteria for discharge of injured workers from TN services
Identify cases that would benefit from additional case management services, such as assignment of a DOL FN
Promote goodwill by assisting all involved parties on issues related to the injured worker/employee, provider relations, and OWCP coordination, as applicable.
Understand the organization's quality management program and the case manager's role within that program
Is an effective team member; supports the team by pitching in at any level and effectively working across the organization to meet the needs of the business
Take ownership of personal actions and outcomes.
Proactively seek opportunities to increase knowledge, skills, and abilities
May perform other duties, as needed, to meet the needs of the business
Embrace change; maintain an open mind and be flexible and adaptable in the face of ambiguity and change
Requirements:
Certification: National certification in case management or related field preferred in one of the following areas: Occupational Health (COHN); Case Management (CCM), Insurance Rehabilitation (CIRS/CRRN), Disability Management (CDMS), and/or Nurse Case Manager Board Certified (ANCC/ANA).
5 years related clinical experience with a minimum of two (2) years adult medical/surgical nursing experience and a minimum of two (2) years case management experience in the workers' compensation arena OR, have a minimum of one (1) year of adult medical/surgical nursing experience and three (3) years of case management experience in the workers' compensation arena.
Bachelor of Science in Nursing preferred.
Experience with Federal Employee Compensation Act (FECA) and FECA-related issues preferable, as applicable.
Excellent verbal, written, and interpersonal communication skills, and organizational and analytical skills.
Superior customer service skills working proactively and collaboratively with client employees and client leaders, medical staff, and co-workers.
Ability to effectively present information.
Excellent team player; ability to partner with internal and external clients and other cross-functional departments. Superior writing and communication skills.
Must write succinctly and clearly and explain complex situations in plain English to technical and non-technical audiences.
Ability to work independently, multitask, and adjust priorities
Ability to utilize a case management system, Electronic Medical Record or other electronic platform
Ability to utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.
Demonstrated ability to use Microsoft applications and demonstrate basic electronic technology understanding
Computer literacy, including MS Word, Excel, and Outlook
Ability to apply logical thinking to a wide range of intellectual and practical problems.
Able to deal with very difficult concepts and complex variables. Ability to comprehend, analyze, and interpret documents.
Ability to solve problems involving several options in situations. Requires intermediate analytical and quantitative skills.
Benefits:
Healthcare Insurance: Synectics offers eligible employees and their dependents healthcare coverage through BlueCross BlueShield of Illinois. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics. Premiums are subsidized by Synectics.
Dental Insurance: Synectics offers eligible employees and their dependents a dental plan through MetLife. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.
Vision Insurance: Synectics offers eligible employees vision insurance through VSP. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.401(k) Plan: The Synectics Inc. Investment Savings Retirement Plan. Synectics offers all employees who are 21 years of age or older the opportunity to invest in the 401(k) Plan on the first enrollment date that is at least 30 days after employment begins. Enrollment dates are each January 1st, April 1st, July 1st, and October 1st.
Technical Certification Bonus: Synectics is pleased to award its employees a bonus of up to $500 for an approved professional certification. In determining the bonus amount, Synectics will consider the cost of the test(s) for any certification relating to your current position, achieved during your employment with us. Only one Certification Bonus per calendar year may be awarded per employee. Only current, active employees will be eligible to receive this bonus. It will be awarded 90 days after the Synectics office has received documentation confirming the successful completion of the certification.
Synectics is an equal opportunity employer.
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