Job Summary
We are looking for a Full-Time Worker's Comp Case Manager to support our client site in Boise, ID.
Schedule:
Monday -Friday/ 8 hour shifts
This is a temporary position expected to last until December 31, 2025.
The Occupational Health Workers' Comp Case Manager is responsible for being the liasion between the onsite clinic, employee, Worker's Compensation carrier, and other providers.
The case manager's primary role is to facilitate appropriate and timely health care with the focus on safe employee return-to-work and the return to maximum functionality. This is accomplished by providing the communication, coordination and education required to optimize outcomes across the continuum of health, disability, workers' compensation, and work-life issues.
The case manager employs best practices that require early intervention and the setting of realistic expectations for disability duration, return-to-work, and return to functionality. Care coordination is a collaborative process that promotes quality of health care, client empowerment, and cost containment by supporting proactive intervention and reducing redundancies.
Responsibilities
- Provides initial contact with injured worker, employer, provider and other appropriate stakeholders (3 point contact) as soon as assignment is received. Discloses information regarding the role of case management and the rationale for the case management relationship
- Maintains contact and communicates with the adjuster assigned to the file through phone calls, email and written reports. Keeps adjuster up to date with activity in case, case direction or secure authorization for services
- Demonstrates positive telephone interaction skills as evidenced by courteousness, open-ended questions to identify problems, and conversation focused on goal directed, time limited communication
- Acts as an advocate for the injured worker with all parties while maintaining the injured worker's privacy and safety. As an advocate for the injured/ill worker in the compensation process, the case manager provides support, information, and education to improve employees' knowledge about their health and self-care, and enhances their understanding of the health care treatment plan and process
- Interacts with WorkCare staff, client site management and safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses
- Collaboration and organization of Case Management spreadsheet for weekly care coordination meetings
- Obtains medical history, diagnosis and treatment plan. Evaluates treatment against evidenced-based guidelines for appropriateness and effectiveness of care and sets realistic expectations for disability duration and return to work early in the treatment plan. Ensures all parties receive appropriate reports
- Assesses and collects data regarding risk factors for delayed recovery and determines the impact on care, recovery and return to work. Generates creative solutions to minimize or eliminate obstacles which prevent or delay RTW
- Arranges for prompt and appropriate medical treatment of an injured worker by qualified providers as per regulations and in collaboration with onsite providers. Ensures appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost. Identifies excessive, ineffective or inefficient delivery of health care services and redirects care as needed and/or allowed
- Works collaboratively with employee to set return-to-work (RTW) goals, including expected return-to-work date. Works with medical providers to track progress and modify treatment plan until maximum medical improvement is achieved. Assures return-to-work clearances are safe and appropriate for all occupational illnesses/injuries
- Must work productively and independently with minimal supervision, maintaining established standards and procedure
- Working over scheduled shifts may be required due to unpredictable nature of workloads.
- Provide additional services to WorkCare as directed by Physician, Department Manager, or Supervisor. May be assigned to special projects or other duties as needed
Qualifications
Education and Experience:
- Case Management Certification preferred
- Minimum 2-3 years' experience with Idaho Case Management/Workers' Compensation processes
- Certification in Disability Management desired
Skills and Competencies:
- Must be able to demonstrate the ability of maintaining privacy and confidentiality; critical thinking skills; make independent decisions in accordance to company policy and procedures; and take initiative on issues that arise daily.
- Accepts personal responsibility for maintaining and improving knowledge and skills.
- Must be competent in these six essential activities and Core Components listed below:
- Six Essential Activities:
- Assessment
- Coordination/Collaboration
- Planning
- Monitoring
- Implementation
- Evaluation
- Core Competencies:
- Process and relationships
- Health care management/reimbursement
- Community resources and support
- Service delivery
- Psychosocial intervention
Computer Skills:
- Must be competent in the Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed.
- Must be able to multi-task between multiple software programs.
- Must have excellent typing skills.
Physical Demands:
- 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.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
- Requires sitting for long periods of time, working at a desk.
- Some bending and stretching required.
- Working under stress and use of telephone required.
- Manual dexterity required for use of calculator and computer keyboard.
- The employee is occasionally required to stand, walk, stoop, kneel and/or crouch.
- Require daily walk to & from parking lot to clinic; may need to navigate uneven walkways and terrain due to construction site.
Work Environment:
- Construction project location.
- Clinic is located within the protected/regulated area.
- Clinic: Mainly indoor, office/clinic conditions; noise level is usually moderate; air quality is good, and temperature is controlled.
Additional Job Information
Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, experience and qualifications.
Benefits for this position include paid time off; medical, dental, vision, and critical illness insurance; HSA, HRA, and FSA; life and disability insurance; EAP; 401K; legal and identity theft coverage; pet insurance and more.
All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other classification protected by applicable laws. WorkCare is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment.
About WorkCare
About WorkCare:
WorkCare, Inc., is a U.S.-based, physician-directed occupational health company with global outreach.
Our mission is Protecting and Promoting Employee Health...from Hire to Retire. We believe Work Matters. Health Counts. Prevention Saves.
Our occupational clinicians and industry subject matter experts deliver integrated, total worker health solutions to employers in all types of industries. Our capabilities include Medical Exams & Travel program management; 24/7 Incident Intervention telehealth triage; Onsite Services & Clinics; Consulting Medical Directors; Clinical Accommodation and Leave Management support; and a full suite of COVID-19 interventions. Our Industrial Athlete and Bio-ergonomic Surveillance programs are designed to prevent and manage work-related strains and sprains.
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WorkCare is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.