RN-- Nurse Case Manager

Overview

AMERISAFE is seeking a detail-oriented, productivity driven professional to add to our “Excellence Team” based in DeRidder, LA. If you love working with great people and want to work on a winning team for an award-winning company known throughout the insurance industry for its high ethics and integrity, then the Nurse Case Manager position is for you.

AMERISAFE is defined by its corporate culture of service. Service at AMERISAFE means delivering on the promises established in our insurance policies, supporting the work activities of our fellow employees, and donating time, talent and resources to our AMERISAFE family and communities. Our employees live out our mission of “providing quality service” not only at work, but in their personal lives as well. These concepts are the foundation of AMERISAFE’S culture and our employees are vital to this mission as we continue to build a better AMERISAFE. We are recognized by Business Insurance as one of the “Best Places to Work in Insurance” and by The Wards Group as one of the “Top 50” insurance companies in America.

AMERISAFE offers a competitive salary, full benefits package and much more. We have many tenured employees across 27 states. In short, employees stay with us because of who we are and what we do  - exceptional people providing workers’ comp for working people. If you’re looking for a career, and not just a job, then AMERISAFE is for you.

AMERISAFE does not consider a person’s race, sex, religion, color, national origin, sexual orientation or gender identification, disability, medical or genetic information, pregnancy, military status, age or any other factor prohibited by law in making hiring, promotion, training, assignment, compensation, discipline, benefits, employment and termination decisions.

In this position, there are no weekends, paid holidays and a Monday through Friday positive work environment. 

Qualifications

• Bachelor’s degree with experience preferred; or must meet the qualifications and obtain Certified Case Management (CCM) certification within three years of employment.
• Active licensure from state (Louisiana) licensing board as a Registered Nurse is required.
• Ability to write letters, summaries and reports using prescribed formats and basic rules of grammar.
• Excellent verbal communication skills are required, to include a good understanding of the industry terminology.
• Ability for make basic calculations and utilize resources to complete complicated mathematical equations, formulas, etc., to assist with investigation or benefit computations.
• Ability to apply principles of rational systems to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Interpret a variety of instructions furnished in written, oral diagrammatic or schedule form.
• Ability to apply principles of logical or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Interpret an extensive variety of technical instructions in mathematical or diagrammatic form.
• Basic use of Windows XP, Outlook and Microsoft Office.

Responsibilities

• The successful individual in this key role will be responsible for:
• Reviewing claim files to obtain the necessary information to assist FCM in appropriate treatment protocols.
• Communicating professionally with medical providers, FCM and other claims staff to obtain needed information to provide appropriate medical case planning.
• Obtaining and reviewing from all contract Nurse Case Managers reports, forms and other medical records necessary to document properly the medical progress of assigned cases.
• Understanding and applying all laws and regulations which apply to the provision of Medical rehabilitation services.
• Providing case management appropriate to the individual injured worker’s needs which may involve, but not be limited to:

                  A) Review Medical records for appropriate options, diagnosis, program, and work capacity.

                  B) Assist in referrals to appropriate therapies.

                  C) Assist in referrals to IME’s and SMO’s, independent medical exams, second medical opinion.

                  D) Assist in referrals for diagnostic testing.

•  Assisting in cost saving for insuring proper utilization of diagnostic testing, durable medical equipment and pharmacy.
• Attending all scheduled supervision meetings, staff meetings, and any other continuing education meetings as needed.
• Maintaining credentials necessary as part of the case manager’s position and adhere to all code of ethics required by these credentials.
• The use of Amerisafe-proprietary tools, ICAMS and Claims Expert.