This is a work from home position requiring local field case management travel.
To provide effective case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and CMSA Standards of Practice and Broadspire Quality Assurance (QA) Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers' Compensation, Group Health, Liability and Disability.
Associate’s degree or relevant course work/certification in Nursing is required.
Minimum of 3-5 years diverse clinical experience and one of the below
Certification as a case manager from the URAC-approved list of certifications;
A bachelors (or higher) degree in a health or human services related field;
A registered nurse (RN) license.
Valid RN licensure in the state(s) the incumbent works in.
Must meet specific licensing requirements to provide medical case management services.
Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is highly preferred. If not attained, must plan to take certification exam within proceeding 24 months and have a minimum of 4 years WC case management experience/demonstrated excellent performance in a similar position with another organization.
Travel may entail approximately 70% of work time.
Must maintain a valid driver’s license in state of residence.
General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
Excellent analytical and customer service skills to facilitate the resolution of case management problems.
Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.
Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.
Think all TPAs are the same? Think again. With Broadspire, our leading global third-party administrator (TPA), Crawford & Company is the consultative outsourcing partner that adapts to businesses’ needs and challenges at any point of the claims processing journey. We offer casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics.
As part of the One Crawford family, Broadspire brings together the best and brightest people in the industry to deliver smart, thoughtful solutions to our clients, and we are guided by our collective value system: RESTORE.
At Crawford, we:
We believe in leading by example – at work and in our communities. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in mission, vision and values. Learn more at www.crawfordandcompany.com.
In addition to a competitive salary, Crawford offers you:
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.