Workers' Compensation Claims Manager jobs in Augusta, GA

JOB TITLE:                               DIVISION:                                REPORTS TO:
Case Manager                         Operations                              Area Director

COMPANY:
We are people who care about people. Our company has a unique history and was founded by two grandchildren of a former Department of Energy worker. Their love and determination for their grandfather to have the best quality care for the best quality of life is what drives our company to provide care for the energy worker population.

POSITION SUMMARY:
Case Managers facilitate services that assist clients in securing medical, social, educational and other services related to their condition(s). This includes an initial evaluation of client’s multiple disciplinary Plan of Care (POC) and identifying appropriate multi-disciplined care services to satisfy a physician's prescribed POC.  Additionally, the Case Manager arranges for multi-disciplinary care to ensure compliance with the POC including recommended adjustments of service needs.  The Case manager coordinates the services with all service providers.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Complete client processes including Plan of Care development, LMN, 60 Day Summaries, and Case Manager Summaries
2. Assess and request care for clients based upon their needs
3. Collaborate with the physician on all visits to secure and maintain in-home care
4. Coordinate nursing care for the client once approved by the Department of Labor for nursing, home health aide, and applicable therapies
5. Regularly assess client health status for acute changes or new diagnoses.  Coordinate with health care providers and facilities to obtain supporting medical documentation
6. Maintain compliance with HIPAA and applicable Health Care Privacy Law
7. Demonstrate effective communication and collaboration with entire care team on behalf of the clients
8. Ensure the maximum number of Clients’ authorized units are served according to Physician orders
9. Ensure client problems are resolved in a timely manner and that clinical care is being provided in the manner prescribed by the attending physician
10. Supervise LPNs and HHAs per state and local regulations
11. Performs other duties as assigned

1. Current registered nursing license in good standing
2. Current CPR certification
3. Experience utilizing an EMR
4. Working knowledge of client-based equipment including but not limited to: manual and/or automatic blood pressure cuff, pulse oximeter, thermometer, multiple oxygen delivery systems, wheelchairs, walkers, lift chairs, and spirometers
5. Experience in an acute/chronic medical field with proven assessment skills
6. Excellent communication and interpersonal skills
7. Ability to work independently and as part of a team
8. Strong organizational and time-management skills
9. Proficiency in Microsoft Office Suite
10. Requires effective analytical and problem-solving skills
11. May require some night and weekend hours to address issues that arise
12. Must pass a criminal background check and drug screen
13. Professional appearance required

1. Ability to sit at a computer terminal for an extended period of time.
2. While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone, keyboard, reach, stoop and kneel.
3. Specific vision abilities required by this job include close vision requirements due to computer work.
4. Regular, predictable attendance is required as business demands dictate.