What are the responsibilities and job description for the medical & disability nurse case manager il position at Liberty Mutual?
Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners.
Follows Liberty Mutuals established standards and protocols to effectively manage assigned caseload of medical/disability cases and by applying clinical expertise assist to achieve optimal outcome and to facilitate claim resolution and disposition.
Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome.
Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome.
Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries.
Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy.
Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner.
Accurately and appropriately documents time tracking for work performed.
Handles special projects as assigned.
Note: You will be required to go into the office twice a week if you reside within a 50-mile radius of our offices in Lake Oswego, OR, Suwanee, GA, Chandler, AZ, Indianapolis IN, Plano, TX, Hoffman Estates, IL, Westborough, MA. Please note that this policy is subject to change.
Ability to analyze and make sound nursing judgments and to accurately document activities.
Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others.
Good negotiation skills to effectively establish target return to work dates and coordinate medical care.
Knowledge of state, local and federal laws related to health care delivery preferred.
Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook).
Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing).
Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience.
Previous medical case management experience a plus.
About UsAs a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow.
We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veterans status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
