Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking a dynamic Telephonic Nurse Case Manager to join our team.
This is an exempt, full-time position that is remote. Days and hours of work are Monday through Friday 8:00 a.m. to 4:30 p.m. ET. Occasional evening and weekend work may be required as job duties demand.
Job Summary
The Telephonic Case Manager position, using discretion and independent judgment, has the responsibility to identify, assess, plan, coordinate, monitor and evaluate medical services for individuals requiring case management services per client contract. The goal of the case manager is to provide quality, cost effective outcomes for the client through collaboration and communication with the claimant, provider, adjusters and other members of the healthcare team. The Telephonic Case Manager also provides and coordinates precertification of diagnostic testing, surgical procedures and peer review.
Responsibilities
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Obtain request for services from adjuster and enter appropriate information into claims system.
- Provides precertification as requested by the adjuster or provider.
- Communicates with provider for medical information and evaluates and assesses appropriateness of treatment. Develops a plan for physical/ medical services and return to work strategies through interdisciplinary collaboration, which identifies realistic short and long-term goals.
- Coordinates medical services and resources to implement plan and reach goals. Negotiates for the highest quality, most cost-effective appropriate services. Identifies cost savings, as appropriate, on assigned cases.
- Demonstrates effective, accurate and timely verbal and written communication on assigned cases.
- Reviews medical billing, as necessary, on assigned claims.
- Maintain Quality Management standards.
- Experience
- Prior telephonic/field case management or Utilization management within the workers’ compensation industry
- CCM (Certified Case Manager) preferred
- Good communication, both written and verbal
- Working knowledge of Windows and typing ability
Required Education And Experience
- Prior telephonic/field case management or Utilization management within the workers’ compensation industry
- CCM (Certified Case Manager) preferred
- Current RN licensure, multistate license preferred
- Minimum one-year direct patient care
Charles Taylor offers a competitive salary commensurate with experience and excellent benefits including medical, dental, vision, life insurance and 401(K) with match. If you are seeking a career where you can achieve great things for great clients in a supportive and collaborative environment, then we may be the place for you.
Values
At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration.
AAP/EEO Statement
Here at Charles Taylor, we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation.
Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive and diverse culture and environment which we are proud to be a part of at Charles Taylor.
About Charles Taylor
We have been providing services to our insurance clients since 1884 and today have over 3,000 staff in 120 locations, spread across 30 countries in the UK, Americas, Asia Pacific, Europe, the Middle East and Africa. Our values are designed to ensure first class-service to clients by creating a diverse and inclusive environment within which our people can thrive.
