Nurse Case Reviewer Jobs (NOW HIRING)

The Nurse Case Management Supervisor is responsible for managing the day-to-day operations and providing leadership to the Nurse Case Managers (NCM) in the Claim Department, ensuring the staff meets or exceeds the company's service quality standards. In addition, this role will work in conjunction with other team members and departments to ensure appropriate levels of care in order to meet company, broker, policyholder, and patient goals. This position requires an ability to be flexible and work with all members of the team and provide ongoing supervision, support, and evaluation to the NCM staff. The Nurse Case Management Supervisor will also fulfill the duties of a NCM as needed.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Provide a workers’ compensation experience that ensures peace of mind for all by listening with empathy, acting with compassion, doing the right thing, and succeeding through collaboration.
• Maintain an engaging work environment by acting and communicating in a manner that cultivates positivity and builds relationships with brokers, policyholders, customers, vendors, co-workers, and management.
• Lead the day-to-day activities of the Nurse Case Management staff, including the assignment of incoming case work and ensuring the quality of the staff’s work.
• Participate in the assessment, evaluation and planning of patient care.
• Conduct regular case reviews, ensuring that all appropriate record-keeping is performed on a timely basis and that all governing agency regulations are met.
• Regularly review case handling to ensure department expectations are being met in regards to contact with injured workers, policy holders and medical providers with a focus on coordinating medical treatment and return to work.
• Work collaboratively with and act as a resource for Nurse Case Managers and/or Claim staff for questions or issues related to diagnosis, treatment, pharmacology, rehabilitation, and clinical selection cases.
• Assist with the identification and development of occupational injury treatment and rehabilitation plans for injured employees.
• Provide direction, manage, coach and develop assigned staff. Provide timely performance reviews based on company service standards. Define and communicate department and organizational expectations.
• Train and provide frequent direction to new staff members.
• Assist HR with the recruitment, hiring, and onboarding of new staff members.
• Keep current with related trends in the case management industry and ensure NCM team maintain licenses by completing the continuing education requirements.
• Adhere to and keep current of all company compliance and security policies and procedures.
• Work with other departments to meet company standards.

The above is a description of the ordinary duties of the position. It should be expected that from time to time other duties, both related and unrelated to the above, may be assigned and required.

Under limited supervision and with broad discretion, the Nurse Case Management Supervisor makes decisions within the scope of their position by following established policies and practices. This position does have an impact on revenue and requires an advanced level of concentration to complete considerably complex tasks.

The Nurse Case Management Supervisor oversees the employees of the NCM team, is responsible for the performance management of the employees within the team and participates in the hiring process when necessary.

This job typically operates in a professional office environment with occasional exposure to light noise.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee will constantly operate a computer and other office productivity machinery, such as a telephone, calculator, copy machine, and computer printer. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and occasionally lift up to 15 pounds.

This is a full-time position. The typical work week is 35 hours with a normal schedule of Monday through Friday,

8:00 AM to 4:00 PM.

Occasional light travel may be required. Travel is primarily local during the business day.

• BSN degree or Bachelor’s degree and comparable work experience
• Certified Case Manager credentials with 3-5 years of active clinical experience within the Workers Compensation case management setting.
• Current nursing licensure in MA and/or other New England states desirable.
• Familiarity with workers’ compensation insurance and claim handling mandatory
• Experience in the management and/or supervision of others, preferably in the nursing field.
• Must have good verbal and written communication skills and be proficient in Microsoft Word, Excel, and PowerPoint.
• Must be able to work independently to organize and prioritize work.

This job description is subject to change at any time.

Associated Insurance Management, LLC (AIM, LLC) complies with all aspects of the Americans With Disabilities Act (ADA) and state disability laws. This means that we will not discriminate against qualified individuals with a disability in any phase of the employment relationship including application for employment, hiring, promotion and /or advancement opportunities, termination, compensation, training, and any other conditions or privileges of employment.