Medical Case Manager

Medical Case Manager - CT08GE

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The Hartford is seeking a Medical Case Manager to work in our Group Benefits department to assist with medical management of disability claims. This position is part of a dynamic, fast-paced team of experienced Medical Case Manager. The ideal candidate for the Medical Case Manager role will oversee disability claims with complex medical conditions referred for medical assessment, clarification of limitations/restrictions or case management. On average, a Medical Case Manager shall manage 50-60 cases. This individual will have the opportunity to collaborate with claims staff, clinical partners, the claimant, medical providers and more.

Responsibilities:

• The successful hire will be responsible for the review of Long-Term Disability (LTD) and Short-term Disability claims with complex medical conditions referred for medical assessment; clarification of limitations/ restrictions; and/or case management.

• Work closely with the STD/LTD Claims Team to identifying appropriate claim referrals and effectively assessing claims to ensure they reach the appropriate claim outcome.

• Collaborate with Rehabilitation Case Managers; Ability Analysts; Employees, Policyholders, Healthcare Providers, and Vendors to facilitate and coordinate case management strategies to facilitate a potential Return to Work. Clearly document and track efforts and outcomes.

• Periodically participate and facilitate training programs and/or presentations.

Qualifications:

• At least 3 years of current clinical experience in an acute care, orthopedic, rehabilitation; industrial medical settings; behavioral health settings, or current experience as a disability case manager.

• Registered Nurse (RN) preferred, will consider candidates with LPN and disability/case management experience. 

• CCM, CDMS, COHN, CRRN or comparable industry certification preferred.

• Clinical ability to assess LTD Claims with complex medical histories which may include claimants with subjective diagnoses, co-morbid conditions, etc.

• Strong written/ verbal communication skills; computers and Microsoft Office programs. 

• Ability to explain complex medical conditions and ability to communicate with attending physicians to identify current limitations/restrictions as it relates to the workplace.

• Accurate clinical assessment and analytical skills, ability to make sound judgments and to accurately document activities, and the desire to learn about the insurance business.

• Prior experience in facilitating RTW for disabled employees, knowledge of return to work best practices, ergonomics, FMLA, and related Human Resources is desired.

• Must keep current in area of expertise and acquire CEU's as necessary to maintain certification. License must remain active and in good standing.

• Negotiation skills, problem solving, plan development competencies are essential. 

• Organizational and Change Management skills, accountability in meeting deadlines, and being a team player are also essential.

Additional Information:

• This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, L