Major Responsibilities:

• Serves as an educator and resource to the employer and injured employee, which includes but not limited to providing health education to enhance the understanding of conditions, treatments and/or procedures and interpreting the care plan and medical results.
• Uses nursing assessment and clinical reasoning skills to assess patient's medical history, current conditions, and response to treatment to develop a plan of care that helps patient progress reasonably through recovery to reach end of healing and return to work. Collaborates with multidisciplinary team and other departments to develop plan of care. If patient is unable to return to work, uses clinical judgment to provide recommendations for disposition, partnering with the physician.
• Coordinates timely, seamless, evidenced based care across the care continuum resulting in best patient outcomes. Ensures smooth transitions between care settings. Uses nursing expertise to help patient navigate through subsequent treatment and follow up.
• Supports the patient and family by providing education, addressing psychosocial needs, advocating, providing continuity of care and identifying barriers to care.
• Collaborates with providers regularly and ongoing regarding patient care plan. Makes suggestions in expediting care and makes modification to a tentative plan on a timely basis, if necessary.
• Facilitates communications between and negotiates with the patient/family, physicians, nurses, dietary, rehabilitation, and other disciplines that need to collaborate to provide care for the patient.
• Identifies, evaluates, and acts to resolve any potential barriers to delivery of care and a timely and appropriate discharge.
• Collects accurate data on outcomes and resource utilization issues and facilitates reporting of utilization monitoring/review activities to the appropriate committees/persons.
• Works closely with the medical staff, hospital departments and ancillary services in expediting care delivery and appropriate documentation to avoid delays in timely service provision. Validates care that is provided.
• Promotes effective professional relationships with physicians, other department members and hospital staff; facilitates problem solving, as appropriate.
• Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.

Licensure, Registration, and/or Certification Required:

• Registered Nurse license issued by the state in which the team member practices.

Education Required:

• Associate's Degree in Nursing.

Experience Required:

• Typically requires 3 years of experience in clinical nursing.

Knowledge, Skills & Abilities Required:

• Position requires working knowledge of the components of quality and patient care needs specifically related to injury care management and knowledge of workers compensation.
• Excellent analytical and interpersonal communication skills necessary to negotiate with families, patient, physicians and third party payers for optimum plan.
• Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.
• Demonstrated ability to take the initiative in responding to employers, communicating with providers to create a clear and concise picture of the injured employee's recovery process.
• Must have the ability to make suggestions on interventions that will expedite employee's return to work.
• Intermediate computer skills including experience in using Microsoft Office (Excel, PowerPoint and Word) or similar products.
• Must be able to prioritize.
• Ability to work with all personality styles, openly communicate AND actively listen.
• Be willing to work w/several disciplines…medical staff, schedulers, radiology, specialists, employers, fellow case manager team, work comp insurance adjusters, external case managers...etc.
• Ability to adapt and adjust communication style based on audience.
• Previous knowledge of how to document & work in EPIC.
• Experience in case management with focus on workers compensation

Physical Requirements and Working Conditions:

• Exposed to normal office and clinical environment.
• Must be able to sit for majority of the workday; stand and walk for the equivalent of several blocks at a time.
• Must lift up to 10 lbs. continuously, up to 20 lbs. frequently, and up to 50 lbs. occasionally.
• Must have functional speech, vision, hearing, and touch with ability to use fine-hand manipulation skills.
• May be exposed to the following hazards: mechanical, electrical, chemical, blood and body fluids; therefore protection clothing and equipment must be worn as necessary.
• Operates all equipment necessary to perform the job.

Additional Information:

• Department is two states, IL and WI. This position will support 2-4 clinics within WI but can be adjusted as the department needs. Will collaborate with 9 other case managers, both from WI and IL.
• Willing to be the public face for worker’s compensation within Occupational Health (i.e. site tours with product experts when called for, outreach to UC/EDs to demonstrate why we are the preferred providers for caring for work injured patients.
• Floating in clinic to support staff – clinical support may be asked as department needs.
• May be asked to work in clinic if needed, be willing to spend some time in clinic, forward facing with the providers/staff.
• Open to meeting with patients in person in clinic if needed as well at onsite company tours and team meetings

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.