Gallagher Nurse Consultant Telephonic Case Management in South Dakota
Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way.
Provides medical management to workers compensation injured employees. Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers.
Essential Duties & Responsibilities:
Manage medical care in order to return injured employee to pre-injury status.
Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling.
Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program.
Evaluates home care services and equipment and determines need for home modifications.
Coordinates home care.
Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary.
Analyzes results of treatment and medical status and reviews incoming provider reports.
Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence.
Generates reports to referral source to communicate case status, findings, and recommendations.
Generates correspondence to referral source, medical providers, injured worker and other parties involved in the rehabilitation process.
Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency.
Documents case management observations, assessment, and plan in system.
Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected.
Associate's degree from an accredited school of nursing
Minimum of 3 years acute clinical experience in an acute care setting
Hold an active RN license within the state of practice.
Worker's Compensation experience preferred.
Certification in related field preferred.
Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice
Demonstrates good written and oral communications, organizational and leadership skills
Demonstrates good time management skills
U.S. Eligibility Requirements:
Interested candidates must submit an application and resume/CV online to be considered
Must be 18 years of age or older
Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
Must have unrestricted work authorization to work in the United States. For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure
Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.
Gallagher believes that all persons are entitled to equal employment opportunity and does not discriminate against nor favor any applicant because of race, sex, color, disability, national origin, religion, creed, age, marital status, citizenship, veteran status, gender, gender identity / expression, actual or perceived sexual orientation, or any other protected characteristic. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
Organization: North America Operations
Title: Nurse Consultant Telephonic Case Management
Location: South Dakota
Requisition ID: 65554
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