Remote Prior Authorization Rn Jobs in Boston, MA

This Field Case Manager will cover our Boston, MA region and must live in this area in order to be considered.

Must be an RN and prefers 1.5 years of prior workers compensation experience.

PRIMARY PURPOSE OF THE ROLE: Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties. While frequent travel is required, you will maintain a home-based office.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment that allows face to face interaction with injured workers and medical professionals.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
• Enable our Caring counts mission supporting injured employees from some of the world's best brands and organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

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ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process.
• Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation.
• Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source

EDUCATION AND LICENSING

RN licensure preferred; or bachelor's degree in health or human services field required with one of the following certifications: CCM, CDMS, orCRC. Valid driver's license required. High speed internet required. Employment may be contingent upon successful completion of a motor vehicle record (MVR) check, where job related.

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

TAKING CARE OF YOU BY

• Offering a blended work environment.
• Supporting meaningful work that promotes critical thinking and problem solving.
• Providing on-going learning and professional growth opportunities.
• Promoting a strong team environment and a culture of support.
• Recognizing your successes and celebrating your achievements.
• We offer a diverse and comprehensive benefits package including:
  • Three Medical, and two dental plans to choose from.
  • Tuition reimbursement eligible.
  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
  • 4 weeks PTO your first full year.

NEXT STEPS

If your application is selected to advance to the next round, a recruiter will be in touch.

#nurse #fieldcasemanager

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $87,000-$92,000 and is bonus eligible. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.