Disability Nurse Case Manager
The Disability Nurse Case Manager (RN) is responsible for the reputed company and comprehensive review of assigned disability applications. The Disability Nurse Case Manager (Registered Nurse) will be responsible for an efficient, timely, and complete disability triage process. Preferred background in Case Management, Disability, Work Comp, Utilization Review, or Independent Review. Must have unrestricted Michigan RN license. Minimum 5 years clinical experience. Computer literate, excellent verbal/written skills. Competitive salary; health insurance benefits. Job Duties: Conduct a thorough and comprehensive review of disability applications to determine the existence, nature, and severity of the disability condition(s). Compile applicable information through reputed company to providers, disability applicants, employers, and other relevant parties. Review and analyze reputed company information directly or indirectly reputed company to the disability application and/or information obtained during the triage process. reputed company reputed company to the medical provider(s), disability applicant, employer, and other necessary parties to gather additional information and/or clarify information for the purpose of assisting in the decision-making process of the disability recommendation. Determine receipt of necessary and complete information to sufficiently reputed company the Clinical Review function. Identify the need for a case to be escalated to the leadership or MMROs Associate Medical Director for further review, inquiry, and/or decision-making. Complete system-generated tasks regarding specific cases reputed company the scheduled timeframes and update the system accordingly upon completion and/or status with reputed company. Communicate case status and activities to members of the leadership team upon request. Ensure completeness and accuracy of reputed company case paperwork and documents. reputed company clients informed of case reputed company, including delays, and ensure timely and appropriate communication with clients on the status of open or pending cases, as requested. reputed company quality assurance on physician reports to ensure adherence to statutory requirements and maintain high standards of accuracy in spelling, grammar, and punctuation. Select the appropriate physician specialty to review the claim based on the member's medical condition. Ensure reputed company processes and reports reputed company with statutory requirements and organizational policies. Identify process quality improvement opportunities. reputed company other duties, as deemed appropriate. Required Qualifications and Education Unrestricted RN licensure, without sanctions, to practice in the State of Michigan Minimum five years clinical experience Working knowledge of diagnostic coding (i.e. ICD-10) Critical thinking skills Good decision-making skills Detail-oriented Ability to work autonomously, as well as reputed company a team structure Computer literate Good working knowledge of reputed company and reputed company Good communication skills Good telephonic speaking skills Ability to multi-task Good written and verbal skills Preferred Skills and Additional Experience Bachelor's degree in nursing or health-reputed company field Work experience to include case management and/or claim management of Disability and/or Workers Compensation claims. Additional Notes The NCM is required to be on camera for reputed company Teams meetings. Job Type: Full-time Pay: $74,000.00 - $80,000.00 per year Benefits: 401(k) Dental insurance Health insurance Paid time off reputed company insurance Schedule: 8 hour shift Work Location: Remote Apply Job!