Medical Case Manager (Remote in Michigan)

Job Title: Medical Case Manager

Location: Remote (must be in Michigan)

ReviewWorks founded in 1989 located in Northville, Michigan.  Provides comprehensive Medical Review Services, Medical Case Management Services and Vocational Rehabilitation Services to customers that include self-insured entities, third party administrators and insurance carriers.

POSITION SUMMARY:  The incumbent develops comprehensive rehab plans and initiates medical management rehabilitation efforts to maximize client recovery and return to gainful employment or independent status 

ESSENTIAL FUNCTIONS:

• Manage a caseload of approximately 15-25 active clients
• Nurse Case Manager is responsible to generate:

• Full-time -  80 billable hours per pay period or a combination of approved nonbillable time plus billable hours to equal 80 hours
• Part-time – 40 billable hours per pay period or a combination of approved nonbillable time plus billable hours to equal 40 hours 

• Develop and implement comprehensive rehabilitation plan by:

• Assessment: Process of collecting in-depth information about a person’s situation
• Planning: Process of determining specific objectives, goals, and actions designed to meet the client’s needs
• Implementation: Process of executing specific case management activities and/or interventions to accomplish the goals set forth in the case management plan
• Coordination: Process of organizing, securing, integrating, and modifying the resources necessary to accomplish the goals set forth in the case of the management plan
• Monitoring: Process of gathering sufficient information from all relevant sources about the case management plan to determine the plan’s effectiveness
• Evaluation: Process of determining the case management plan’s effectiveness in reaching desired outcomes and goals

• Timely comprehensive report and documentation of services provided
• Personal visits and local travel to clients, physicians, hospitals, agencies, schools and employers
• Perform other duties as assigned by Supervisor 

PROFESSIONAL BACKGROUND:

• Experience as a professional Rehabilitation Case Manager in the Private Sector with a full-time caseload of WC and Auto No-Fault recipients or related experience
• Extensive knowledge of Michigan Worker’s Compensation and Auto No-Fault Insurance coverage

Medical: 

RN with current license

Five years of nursing minimum

Credentials: 

CRRN or CCM preferred

Obtain CCM when eligible

Orthopedic and/or rehab experience preferred

SKILLS AND ABILITIES REQUIRED TO PERFORM ESSENTIAL FUNCTIONS:

• PC skills – Required 
• Knowledge of Microsoft Office, Lotus Notes, Advocate – Helpful 
• Ability to drive a distance of 100 miles one way – Required 
• Ability to drive a distance of 300 miles one way – Occasionally 
• Written communication skills
• Telephone skills
• Ability to walk up one flight of stairs
• Ability to lift 20 pounds

PERSONAL CHARACTERISTICS: 

Initiative, drive, creativity, and persistence, Good organizational skills, Highest professional skills