About the position
In this primarily virtual role, the selected candidate will manage a caseload of complex cases, applying specialized training and knowledge to assess each case effectively. The position requires a thorough review, recording, and analysis of medical records and treatment plans, ensuring that they align with duration control guidelines while clarifying any functional inconsistencies that may arise. The role is pivotal in providing technical insight and advice to the team regarding employees' current or potential functional abilities, which is essential for developing effective return-to-work plans. The candidate will be responsible for creating goal-focused return-to-work plans that address any barriers preventing employees from returning to work. This involves facilitating communication between the employee, physician, and employer, and partnering with all parties to achieve positive outcomes. The role also requires adherence to established claim policies and practices to resolve any claims issues that may occur. Additionally, the candidate may be assigned other related duties as required, contributing to the overall success of the team and the organization. This position is based in Cary, NC, Oriskany, NY, or Tampa, FL, and while it is primarily virtual, there will be in-person training and collaboration days. Candidates must be within a commutable distance of one of these office locations to facilitate occasional in-person meetings and training sessions.
Responsibilities
- Manages assigned caseload of complex cases; applies specialized training/knowledge to the assessment of cases; provides technical insight and advice.
- Reviews, records, and analyzes medical records and treatment plans data and compares duration control guidelines and clarifies functional inconsistencies.
- Provides recommendations to team regarding employee's current or potential functional abilities.
- Develops goal-focused return-to-work plans; addresses barriers for return to work.
- Facilitates communication between employee, physician and employer and partners with all parties to achieve a positive outcome.
- Follows established claim policies and practices to resolve claims issues.
- Performs other related duties as assigned or required.
Requirements
- Master's Degree in Clinical Psychology or Social Work; if Registered Nurse will accept associate degree or higher with current RN state license. BSN Preferred.
- 2+ years of experience in inpatient or intensive outpatient or outpatient therapy in a clinical setting.
Nice-to-haves
- Licensure in Clinical Psychology or Social Work.
- Disability insurance or workers compensation case management, private rehabilitation risk management, occupational health, or rehabilitation facility experience is highly preferred.
- Solid verbal and written communication skills.
- Analytical and critical-thinking skills.
- Deep and broad technical knowledge of medical conditions, prognosis, and treatment.
- Basic understanding of the disability contract, its key provisions, and the implication of those provisions.
