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. Please contact Anne Llewellyn for information on this opportunity. You can reach Anne via email at email@example.com or by phone at 954-254-2950
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Job Opportunities Posted as of August 9, 2017
Opening is for CONTRACT Medical Case Manager needed in all areas of FL and surrounding southern states.
Applicants MUST HAVE: 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 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 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
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
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 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 assigned geographical region for introduction to identify geographical healthcare trends in 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.