Telephonic Nurse Case Manager (RN)

Our client is seeking a (RN) Telephonic Nurse case manager to join their team in Sioux Falls, SD. The Telephonic Medical Case Manager (RN) will focus on providing an emphasis on early intervention, return

to work planning, coordination of quality medical care on claims involving restricted duty and medical

treatment as well as in-house medical reviews as applicable to claim handling laws and regulations. This

position will be responsible for helping to ensure injured parties receive appropriate treatment directly related to their work injury.

Essential Job Functions:

 Contact medical providers and injured parties on claims involving medical treatment and/or disability

to coordinate appropriate medical care.

 Develop medical management strategy and give the provider information necessary to facilitate a

return to work plan on claims requiring disability management.

 Responsible for ongoing evaluation of treatment and return to work plan within established protocols

and/or guidelines.

 Work with medical providers and suggest cost effective treatment alternatives when appropriate.

 Obtain medical records from providers telephonically and/or through written follow-up as necessary.

 Work directly with the employer, injured party, and provider to expedite return to work by obtaining

job descriptions and identifying appropriate job modifications as necessary.

Knowledge and Skills required:

1. Education/Experience

 Degree from an accredited nursing school required, Bachelor of Science in nursing preferred.

 Minimum 1 years clinical practical experience required.

 Experience in medical case management, insurance case management, orthopedic, occupational

health, critical care, or rehab care is preferred.

 CCM (Certified Case Manager ) preferred however must be willing to obtain within 3 years.