The South Florida Case Management Network is committed to the growth and development of the case management community in South Florida. To assist those who are seeking case management positions in the South Florida area, the Board of Directors has offered Members of the South Florida Case Management Network to post job opportunities on our website as well as in our Monthly Newsletter. If you are not a member of SFCMN, we will also post you job opening at a cost of $65.00 per ad. You can pay the fee via PayPal at http://www.sfcmn.com/?page_id=874. Once you pay, please email Anne Llewellyn with your job opening. You can reach Anne via email at email@example.com or by phone at 954-254-2950
Case Managers, bookmark the site and check back often for new opportunities. Please share with your colleagues.
Job Opportunities Posted as of August 24, 2017
The ALARIS Group is looking for Field Nurse Case Managers in the state of Florida. We have openings in the areas of Fort Lauderdale, Jacksonville, Miami, Orlando, and Tampa. ALARIS has been awarded as a top workplace and national Best and Brightest company. ALARIS is the nation’s largest independent healthcare management firm specializing in workers’ compensation case management.
This individual is responsible for the medical case management of work related injuries which includes assessment, planning, coordination, implementation and evaluation of. injured/disabled individuals. The Case Manager works with insurance carriers, medical care providers, attorneys, employers, and employees, and closely monitors the progress of the injured worker and reports results back to the employer and insurance carrier. The work of the Case Manager also helps ensure appropriate and cost-effective healthcare and wellness services, both on and off-site with area employers.
We offer a unique work environment that encourages autonomy and independence and utilizes a sophisticated virtual office.
- Current Registered Nurse (RN) license in FL
- Workers Compensation case management experience is preferred.
- Excellent organization and timeline adherence skills
- Excellent PC and technology skills
- Excellent communication skills- written, verbal and interpersonal
- Valid Drivers License, and good driving history
Visit our careers page to view all openings, join our talent network, and apply!
Broadspire, a Crawford Company seeks a Registered Nurse – Medical Case Manager with National Certification Required
Requisition ID: 2017-1621
Job Locations US-FL-Miami
Posted Date: 6/30/2017
To apply for this position follow this link https://careers-crawco.icims.com/jobs/1621/registered-nurse—medical-case-manager-%28national-certification%29/job?in_iframe=1
This is a work from home position requiring local field case management travel.
Nurse Case Manager wanted to provide effective case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and CMSA Standards of Practice and Broadspire Quality Assurance (QA) Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers’ Compensation, Group Health, Liability, and Disability.
- Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual’s medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.
- Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.
- Demonstrates the ability to meet administrative requirements, including productivity, time management, and QA standards, with a minimum of supervisory intervention.
- May perform job site evaluations/summaries to facilitate case management process.
- Facilitate timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with the injured worker, employer, and physicians.
- Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.
- May obtain records from the branch claims office.
- May review files for claims adjusters and supervisors for appropriate referral for case management services.
- May meet with employers to review active files.
- Makes referrals for Peer reviews and IME’s by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.
- Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.
- May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.
- Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.
- Reviews cases with supervisor monthly to evaluate files and obtain directions.
- Upholds the Crawford and Company Code of Business Conduct at all times.
- Demonstrates excellent customer service, and respect for customers, co-workers, and management.
- Independently approaches problem-solving by appropriate use of research and resources.
- May perform other related duties as assigned.
- Associate’s degree or relevant course work/certification in Nursing is required.
- Minimum of 3-5 years diverse clinical experience and one of the below
- Certification as a case manager from the URAC-approved list of certifications;
- A bachelors (or higher) degree in a health or human services related field;
- A registered nurse (RN) license.
- Valid RN licensure in the state(s) the incumbent works in.
- Must meet specific licensing requirements to provide medical case management services.
- Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is highly preferred. If not attained, must plan to take certification exam within proceeding 24 months and have a minimum of 4 years WC case management experience/demonstrated excellent performance in a similar position with another organization.
- Travel may entail approximately 70% of work time.
- Must maintain a valid driver’s license in state of residence.
- General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
- Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
- Excellent analytical and customer service skills to facilitate the resolution of case management problems.
- Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.
- Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.
BSN Degree is preferred.
Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology, and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the United States. Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the United Kingdom (www.BroadspireTPA.co.uk).
In addition to a competitive salary, Crawford offers you:
- Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;
- On-going training opportunities through every stage of your career
- Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
- Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
- Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.
REHABILITATION CASE MANAGEMENT, INC. has an opening for CONTRACT Medical Case Manager needed in all areas of FL and surrounding southern states.
Applicants MUST have one of the following national certifications: CCM, CDMS, COHN OR CDMS certifications + RN.
This is a field position in which the Medical Case Manager coordinates resources and creates flexible, cost-effective options for injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. Area travel required with travel & mileage reimbursement. Work from home.
Flexible days/hours. Can work as many or little hours as possible. Great for semi-retired, part time etc.
Essential Job Duties:
- Responsible for assessment and coordination of medical care related to Workers Compensation Injured Workers.
- Works closely with adjusters, medical providers, employers, and attorneys to ensure appropriate medical care, medical rehabilitation, and return-to-work.
- Requires excellent assessment skills and ability to work independently. Must be able to develop and foster excellent working relationships with referral sources.
- Case Managers must be proactive and assertive in the implementation of treatment plans and resolution.
- Must have strong computer skills.
- LTC Insurance Assessments require only RN + geriatric experience. Combines well with Workers comp work.
- Assessments are done in home and facilities.
Minimum education: Associate degree. Must hold an unencumbered RN license in State of practice. Compact license or licenses in other states, a plus.
Application Instructions: To apply for this position, please email resume and cover letter to Simone Choi at firstname.lastname@example.org or fax 305 253 5136.Visit our web page: www.rehabcasemgt.com
Join a team of GENEX case managers who are committed to changing injured workers’ lives for the better” Make a difference in the lives of injured workers. Become part of an industry-leading organization by teaming up with the largest provider of case management in workers’ compensation!
Opportunity: We are currently seeking a Bilingual (English/Spanish-speaking) Medical Nurse Case Manager (RN) for the Fort Lauderdale/Miami, FL area. Must have either CCM, CDMS, CRRN or COHN. Work from home position. We are looking for candidates who have at least two years of clinical experience in nursing or rehabilitation. Genex’s expert case managers manage the entire continuum of care for injured workers, from injury through return to work.
They are responsible for assessing, planning, coordinating, implementing, and evaluating injured workers through the medical case management process. They work as intermediaries between carriers, attorneys, medical care providers, employers, and employees to ensure appropriate and cost-effective health care services.
Responsibilities include but not limited to:
- Compiling a case inventory on a monthly basis for submission to the branch manager to allow for proper billing and to calculate hours for bonus purposes.
- Completing insurance carrier reports on a monthly (or as required) basis, as well as other necessary paperwork for the insurance company, state, or other regulatory bodies.
- Maintaining the necessary credentials and demonstrates a level of professionalism within the work place and in dealing with injured workers reflects positively on the company as a whole.
- Acquiring and maintaining knowledge of developments in the medical case management field.
- Keeping abreast of local workers’ compensation laws and regulations, as well as other issues related to the case management/managed care industry.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Bilingual (English/Spanish-speaking) skills are preferred
- Diploma, Associate or bachelor’s degree in nursing or bachelor’s degree (or higher) in a health or human services related field required. Masters level and/or advanced study in a health-related field desired.
- Minimum of two (2) years full-time equivalent of direct clinical care to consumers required. Case Management and/or Workers’ compensation-related experience strongly preferred.
- Registered nurse with current, valid state licensure required.
Interested candidates can fax their resumes confidentially to 1-800-810-4831
MKCM- A Growing National Case Management Company is looking for EXPERIENCED only INDEPENDENT Workers Compensation field case managers throughout the United States. If you have a minimum of 5 years field experience and are looking to join an amazing team of case managers across the country please contact Mollie Kallen, President at Mollie@mkcminc.com or 954-347-5016.
We are looking for strong veterans who have a deep knowledge of providers in their areas and who aggressively work their files. We believe in minimal admin and you get paid full professional for travel and wait time.
Best part is that you are working cooperatively with all the other case managers that are tops in the field and making a difference in the lives of our injured workers/employers/customers.
Reach out today or pass this along to someone who might fit the above criteria.
SYMETRA LIFE INSURANCE COMPANY” has an immediate opening for RN Case Manager – Stop Loss. The position is responsible for assisting Stop Loss Underwriters in evaluating potential medical treatment cost of individuals identified in new and renewal business underwriting process to provide estimated claim risk for current and upcoming policy periods. They also act as a resource to Policyholder’s Third Party Administrator and Case Management Vendor with care and cost management oversight of potential stop loss claimants.
- Review policyholder data to identify claimants with catastrophic care needs and assess medical & claims information available to calculate potential risk. Provide written claimant assessments within established deadlines to the Underwriters/RGM’s to utilize when establishing rates for new and renewal business.
- Review potential stop loss claim notices to identify case management and cost containment opportunities to reduce potential excess loss claim expenses. Notify appropriate management and underwriters of potential claims involving significant risk. Work with Third Party Administrators (TPAs) and external Case Managers utilizing medical and claims management resources to facilitate clinical and financial outcomes for claimants with complex and catastrophic medical conditions. Maintain current claimant clinical status, cost containment activities and contact information in ESL.
- Act as a resource to internal and external customers by:
- Identifying and supporting training opportunities for Claims, Underwriting, Sales, and TPA when knowledge gaps are identified.
- Providing clinical opinion from knowledge, experience and/or research to claims examiners and underwriters as requested or deemed appropriate.
- Assessing and recommending effective claim cost containment and managed care vendors including preferred provider networks in the assigned geographical region for an introduction to identify geographical healthcare trends in the assigned geographic marketplace for potential solution implementation and to warn Underwriting and Sales of any risk impacting trends identified.
- Represent Symetra at Industry Conferences attending educational sessions to gain awareness of new diagnoses, treatments, costs and industry trends. Maintain CE hours to meet State RN Licensure and CCM (or Industry) certification renewal requirements. Author educational articles to share industry news with internal contacts. Project leadership and participation as needed.
- Bachelor’s degree in related field
Minimum Years of Related Work Experience Required:
- Four or more years nurse clinical (preferably hospital based) experience and Two or more years case management experience
Specific Industry and/or Specialty Experience Required:
- Two or more years of experience in health care or health insurance industry; stop loss or reinsurance preferred
Specific Licensing, Designation and/or Training Required:
- Registered Nurse
Education/Experience/Licensing Training/Skills/Abilities PREFERRED:
- Case Manager Certification (CCM)
Skills and Abilities Required:
- Ability to use varying resources to research diagnoses, treatments and average costs
- Ability to work independently and in team environment
- Strong customer service attitude
- Ability to develop unified internal and external working relationships
- Ability to multi-task and adapt promptly to change
- Strong prioritizing and organization skills
- Ability to communicate effectively with others using the spoken word
- Ability to communicate effectively in writing clearly and concisely
- Ability to utilize available time to organize and complete work within given deadlines
- Strong computer proficiency (MS Word, Outlook, Excel and PowerPoint)
How to apply
Symetra is a dynamic and growing financial services company with 60 years of experience and customers nationwide. In our daily work delivering retirement, employee benefits, and life insurance products, we’re guided by the principles of VALUE, TRANSPARENCY AND SUSTAINABILITY. That means we provide products and services people need at a competitive price, we communicate clearly and honestly so people understand what they’re getting, and we build products that stand the test of time. We work hard and do what’s right for our customers, communities and employees. Join our team and share in our success as we work toward becoming the next national player in our industry. Visit www.Symetra.com.