Providing quality service and accurate results supports Ascential Care Partner’s primary mission as a trusted adviser to our clients. As a Telephonic Nurse Case Manager, you will be working in a fast-growing company and work environment. Your valuable role requires working closely with treating physicians/providers, employers, claim representatives, legal representatives, and the injured/ disabled person to create and implement safe and effective Return to Work plans, and facilitate appropriate and cost-effective medical services to achieve maximum medical improvement and recovery. As a member of our team, you will continue to reinforce Ascential’s mission of being a market leader and collaborative partner to current and prospective customers and partners.

Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential

functions.

Case Management & Application of Knowledge:

• Demonstrate and apply knowledge of case management standards, injuries, medications, treatment

• options, and job duties to advise on and implement treatment plans

• Adhere to ethical guidelines and best practice standards, ensuring quality of care.

Collaboration & Communication:

• Collaborate telephonically and in writing with claims representatives, employer when applicable, and healthcare providers to achieve optimal return to work and claim outcomes

• Facilitate telephonic and written communication and coordination with all appropriate parties

• Maintain regular, frequent telephonic and written contact with patients throughout the claim

• assignment

• Involve patients in decision-making and encourage their appropriate use of healthcare services to maximize health outcomes and maintain cost-effectiveness.

Patient-Centered Care & Advocacy:

• Assess patient needs, provide support and advocacy, promote self-advocacy and self-determination

• Assist in safe transitioning of care, and resolve problems using multidisciplinary strategies, always prioritizing patient needs

Documentation & Confidentiality:

• Maintain accurate documentation of case management services in client records

• Uphold patient confidentiality and adhere to HIPAA standards.

Quality Assurance:

• Ensure quality of care by adhering to standards, measuring outcomes, making necessary adjustments, and following ethical guidelines.

• Reflect the company’s philosophy by demonstrating ardent customer service-related results.

Professional Development:

• Maintain professional and industry knowledge through continuous learning, networking, and participation in professional activities.
• Maintain state license(s) and certifications required for this role.

Workload Management:

• Manage assigned workload independently, prioritizing cases, evaluating progress, and modifying goals to improve treatment effectiveness and claim outcomes.
• Perform other duties as assigned

Skills/Qualifications:

• Credentials:

• Current, active, and, unencumbered Registered Nurse (RN) license in applicable state (California Required)
• Certification in the case management field preferred. Recognized certifications include CCM (Preferred) A-CCC, CCM, CDMS, CMAC, CMC, CRC, CRRN, and COHN

Experience:

• Two or more years’ full-time work providing direct clinical care
• Experience in worker's comp case management, occupational nursing, or related field preferred

Education:

• Associate degree or bachelor’s degree in nursing

Required Skills:

• Able to think critically and strategically to accomplish case goals
• Excellent interpersonal skills, and customer service focused
• Assertive and proactive in approach and communications
• Maintains confidence and tact in difficult discussions and collaborations to achieve positive outcomes
• Possesses strong organizational, task prioritization, and delegation skills
• Demonstrates technical proficiency in Microsoft Office products and ability to learn new software
• Ability to maintain accurate records, prepare reports, correct English usage, and maintain confidentiality
• Ability to construct grammatically correct reports using standard medical terminology
• Ability to use a computer keyboard and mouse up to 8 or more hours per day
• Bilingual Spanish highly desired

Work Setting:

• Full-time, work from home position that can be located anywhere in the U.S.
• Ability to work normal business hours in Mountain or Pacific Time Zone
• Must have dedicated home office space that ensures privacy with access to reliable high-speed internet

Physical Demands

While performing the duties of this position, the employee is required to walk, stand, bend, kneel, stoop, communicate, reach, and manipulate objects. Duties involve moving materials weighing up to 10 pounds on a regular basis such as files, books, office equipment, etc., and may infrequently require moving materials weighing up to 30 pounds. Manual dexterity and coordination are required while operating equipment such as computer keyboard, calculator, and standard office equipment.

Other Duties

Please note this TCM job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Equal Opportunity Employer, M/F/D/V

Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status.  California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant.
 

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