Worker’s Compensation Clinical Case Manager

Location: GA/MI Markets Employee type: Full-Time

Reports to: Director of Occupational Services

Job Description

The Worker’s Compensation Case Manager (WCCCM) oversees management of workers compensation patient care with an understanding of Georgia Workers Compensation and OSHA guidelines. The WCCCM maintains communication with the company contacts from the companies that utilize WellStreet services for workers compensation and occupational medicine. The WCCCM works directly with the Director of Occupational Services, Work Comp Coordinators, Occupational Services Team, Business Management Sales Team, Senior Medical Director (SMD), Regional Medical and Area Clinical Directors, Senior Director of Operations (SDO), Team Leads (TL), Practice Managers, and Clinical Staff Members to ensure WellStreet meets its goal of producing high quality, patient-focused health care services that is understanding of the needs of the employers that we serve.

Essential Duties and Responsibilities

Serves as liaison between medical providers and injured workers for coordination and render opinions regarding case treatment plan, outcome, and problem areas, and makes recommendations to facilitate case management goals to include RTW.

Proactively manages all active claims to assess progress/response to treatment, prevent lapses or delays in treatment, obtain regular updates on work status and facilitates injured worker’s return to work.

Communicates with company contacts to manage workers compensation and occupational medicine needs and responds to calls from employers, providers, and staff members in a timely manner.

Has flexibility in their schedule and work location.

Provide updates to the management team to facilitate growth and maintenance of the workers compensation and occupational medicine services.

Understands and able to communicate OSHA regulations and Workers Compensation laws as it pertains to patient care for the respective state.

May perform job site evaluations/summaries to facilitate case management process. Participate in occupational medicine patient care as needed.

Take call after hours, weekends and holidays as needed.

Other duties as necessary.

Qualifications and Required Skills:

Valid Occupational Health Nurse, Paramedic, RN, or LPN licensure in GA

Basic computer skills including working knowledge of Microsoft Office products Critical thinking (goal setting, creative problem solving)

Verbal, written and presentation skills across varying professional levels (company contacts, patients, physicians, clinical staff, senior leadership)

Managing competing priorities

Building and maintaining cross-functional relationships Well organized, focus on accuracy and attention to detail.

Self-starter, able to work independently as well as with others.

Minimum of 1 year of related experience in Occupational Health is preferred

INDPUC