Medical Case Manager
As Medical Case Managers, we seek to improve on our patients abilities! This position is part of a dynamic, fast-paced team of experienced Medical Case Managers located remotely across the United States. The ideal candidate for the Medical Case Manager role will oversee Short Term, Long Term and Premium Waver disability case files. On average, a Medical Case Manager shall handle 65-75 cases with a moderate degree of complexity and acuity of medical condition. This individual will have the opportunity to collaborate with claims staff, the injured worker, an employer, and other healthcare professionals to promote quality medical care with a focus on returning our patients back to work. Our goal is to achieve optimum, cost-effective medical and vocational outcomes. We embrace The Hartford Behaviors of Delivering Outcomes, Teamwork, Building Strong Partnership and Striving for Excellence!
- The successful hire will be responsible for the review of Long-Term Disability (LTD), Short-term Disability (STD) and Premium Waver (PW) claims with complex medical conditions referred for medical assessment; clarification of limitations/ restrictions; and/or case management.
- Work closely with the STD/LTD/PW Claims Team to identifying appropriate claim referrals and effectively assessing claims to ensure they reach the appropriate claim outcome.
- Collaborate with Rehabilitation Case Managers, Ability Analysts, Employees, Policyholders, Healthcare Providers and Vendors to facilitate case management strategies to a potential Return to Work.
- Clearly document and track efforts and outcomes.
- Periodically participate and facilitate training programs and/or presentations
- At least 3 years of current clinical experience in an acute care, orthopedic, neurological, physical rehabilitation, industrial medical settings or current experience as a Disability Case Manager
- Registered Nurse (RN) preferred, however we will consider candidates with LPN and Disability/Case Management experience
- CCM, CDMS, COHN, CRRN or comparable industry certification preferred.
- Clinical ability to assess Disability Claims with complex medical histories which may include claimants with subjective diagnoses, co-morbid conditions, etc.
- Strong written/ verbal communication skills; computers and Microsoft Office programs.
- Ability to explain complex medical conditions and ability to communicate with attending physicians to identify current limitations/restrictions as it relates to the workplace.
- Accurate clinical assessment and analytical skills, ability to make sound judgments and to accurately document activities, and the desire to learn about the insurance business.
- Prior experience in facilitating RTW for disabled employees, knowledge of return to work best practices, ergonomics, FMLA, and related Human Resources is desired.
- Must keep current in area of expertise and acquire CEU's as necessary to maintain certification.
- Negotiation skills, problem solving, plan development competencies are essential
- Organizational and Change Management skills, accountability in meeting deadlines, and being a team player are also essential
Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age