PURPOSE OF POSITION:
The primary purpose of the Case Manager is to perform assigned duties in an efficient, cost- effective manner according to established policies and procedures of the Ohio Bureau of Workers Compensation (BWC) and AultComp MCO. The role of the Case Manager is to provide client-centered care in order to educate, advocate for, and empower the client by coordinating resources and facilitating communication within all parties to the claim to promote an early and safe return to work. Some responsibilities may be shared with other personnel. The Case Manager must provide efficient, quality service at all times. The Case Manager will accomplish this goal by the timely coordination of quality services to meet an individual's specific health care needs in a cost-effective manner.
RESPONSIBILITIES & EXPECTATIONS:

• Provides case management services with the goal of medical stability and safe return to work
• Anticipate and follow through with both internal and external customer requests to their satisfaction.
• Seek and provide assistance of/to others and other departments when needed.
• Process Improvement: Continuously reviews, recommends and implements improvement steps, as needed or directed.
• Seeks supervisory guidance/approval as appropriate.
• Portrays professional image: follows dress code; communicates with internal and external customers in a professional manner, including appropriate verbal and written grammar.
• Maintain confidentiality or enrollee and employer information at all times.
• Comply with policies, procedures and code of conduct, Ohio Nurse Practice Act, National Association of Social Workers Code of Ethics, Case Management Society of America Standards, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other governing and accrediting bodies.
• Utilize the CMSA Standards of Practice for Case Management to assess needs, establish realistic goals, and facilitate an appropriate plan in concert with client/family, facility, and other health care professionals while promoting a cost-effective use of resources.
• Promotes and demonstrates professional standards to enhance the development of the department including:
  • Performs all job functions in an independent manner (as needed or directed)
  • Recognizes and performs job functions with little or no supervision
  • Demonstrates strong organizational skills
  • Responds positively to change in work flow as needed
  • Offers assistance to co-workers (as needed)
  • Maintains flexibility to meet department needs, including adjusting work hours
  • Consistently completes assigned work in required time frame; completes other duties as required
  • Collaborates and cooperates with co-workers, supervisors, etc., creating a productive working relationship throughout the organization
  • Actively seeks and pursues opportunities to make a contribution and demonstrates desire for learning
  • Maintain accurate and complete documentation in electronic medical management systems
  • Assumes responsibility for on-going continuing education and/or professional development
• Practices Ethical Conduct:
  • Demonstrates honesty and integrity in all functions and relationships
  • Maintains AultComp MCO standards of confidentiality, including established BWC and/or AultComp MCO privacy guidelines.
  • Complies with policies and procedures at all times
• Meets acceptable attendance and punctuality expectations (excluding FMLA)

The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified, and shall not be considered as a detailed description of all the work requirements that may be inherent to this position.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender identity, sexual orientation, or protected veteran status. AultComp MCO is an EEO/AA Employer M/F/Disability/Vet.
QUALIFICATIONS:

• A current, unrestricted license or certification to practice a health or human services

discipline in the State of Ohio and that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline;

• Two years full-time equivalent providing direct clinical care.
• A bachelor's degree or higher in a health related field is preferred.
• Certification as a case manager or willingness to attain certification within four (4) years of date of hire.

• Maintains professional licensure/certification.
• Remains current in educational areas related to job description.
• Organized self-starter with focus on goals and deadlines.
• Previous experience utilizing spreadsheet, database or related software preferred.
• Demonstrates ability to handle frequent interruptions in a courteous and professional manner.
• Demonstrates ability to effectively communicate with various customers.
• Demonstrates ability to work independently and effectively perform several different duties.
• Demonstrates ability to meet deadlines.
• Demonstrates ability to utilize information systems within scope of position.
• Requires excellent interpersonal skills and evaluation skills.

WORKING CONDITIONS:

• Hours of operation, shifts as assigned. Occasional overtime, on-call, off-shifts (evenings and/or weekends) scheduled as necessary.
• Lunch and break periods must be coordinated with other staff members to maintain adequate office staffing during departmental operating hours.
• Sitting/standing/moving about intermittently during working hours.
• Subject to frequent interruptions and changes in priority of duties throughout the day.
• Physical requirements checklist. (See Attachment)
• Hazardous Exposure Category: 3

PHYSICAL REQUIREMENTS ADDENDUM:
Purpose: To identify specific functions job requirements and work environment factors that could affect job performance.
Check all factors that are present as essential job requirements and check whether the factor is performed.
O = Occasionally = 0- 33% of the work shift or 0- 32 repetitions.
F = Frequently = 34-66% of the work shift or 32-200 repetitions.
C = Constantly = 67-100% of the work shift or 200 repetitions.
N = Not essential job requirement.
O Standing
F Walking
O Lifting (70 pounds)
O Carrying (70 pounds)
O Pushing (70 pounds)
N Climbing with (70 pounds)
O Stooping/Bending
O Twisting/Turning
O Kneeling/Squatting
N Crawling
F Reaching Up/Reaching Forward
Additional information concerning physical requirements for the position:
Lifting, Carrying, Pushing, and Climbing with record storage boxes, tapes, and copy paper cases. Majority of the time is spent working with data entry and system coordination.
HAZARDOUS EXPOSURE CATEGORY:
Category III - tasks that involve no exposure to blood, body fluids, or tissues.