RN Telephonic Case Manager

Providing quality service and accurate results supports Ascential Care Partner’s primary mission as a trusted adviser to our clients. As a Telephonic Nurse Case Manager, you will be working in a fast-growing company and work environment. Your valuable role requires working closely with treating physicians/providers, employers, claim representatives, legal representatives, and the injured/ disabled person to create and implement safe and effective Return to Work plans, and facilitate appropriate and cost-effective medical services to achieve maximum medical improvement and recovery. As a member of our team, you will continue to reinforce Ascential’s mission of being a market leader and collaborative partner to current and prospective customers and partners.

Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential

functions.

· Case Management & Application of Knowledge:

o Demonstrate and apply knowledge of case management standards, injuries, medications, treatment

options, and job duties to advise on and implement treatment plans

o Adhere to ethical guidelines and best practice standards, ensuring quality of care.

· Collaboration & Communication:

o Collaborate telephonically and in writing with claims representatives, employer when applicable, and

healthcare providers to achieve optimal return to work and claim outcomes

o Facilitate telephonic and written communication and coordination with all appropriate parties

o Maintain regular, frequent telephonic and written contact with patients throughout the claim

assignment

o Involve patients in decision-making and encourage their appropriate use of healthcare services to

maximize health outcomes and maintain cost-effectiveness.

· Patient-Centered Care & Advocacy:

o Assess patient needs, provide support and advocacy, promote self-advocacy and self-determination

o Assist in safe transitioning of care, and resolve problems using multidisciplinary strategies, always

prioritizing patient needs.

· Documentation & Confidentiality:

o Maintain accurate documentation of case management services in client records

o Uphold patient confidentiality and adhere to HIPAA standards.

· Quality Assurance:

o Ensure quality of care by adhering to standards, measuring outcomes, making necessary adjustments,

and following ethical guidelines.

o Reflect the company’s philosophy by demonstrating ardent customer service-related results.

· Professional Development:

o Maintain professional and industry knowledge through continuous learning, networking, and

participation in professional activities.

o Maintain state license(s) and certifications required for this role.

· Workload Management:

o Manage assigned workload independently, prioritizing cases, evaluating progress, and modifying goals

to improve treatment effectiveness and claim outcomes.

o Perform other duties as assigned

​Skills/Qualifications:

• Credentials:

o Current, active, and unrestricted RN license. Compact license preferred.

o Additional licensure in CA, NY highly desired

o Certification in the case management field preferred. Recognized certifications include CCM (Preferred) A-CCC, CCM, CDMS, CMAC, CMC, CRC, CRRN, and COHN

• Experience:

o Two or more years’ full-time work providing direct clinical care

o Experience in worker's comp case management, occupational nursing, or related field preferred

• Education:

o Associate degree or bachelor’s degree in nursing

• Required Skills:

o Able to think critically and strategically to accomplish case goals

o Excellent interpersonal skills, and customer service focused

o Assertive and proactive in approach and communications

o Maintains confidence and tact in difficult discussions and collaborations to achieve positive outcomes

o Possesses strong organizational, task prioritization, and delegation skills

o Demonstrates technical proficiency in Microsoft Office products and ability to learn new software

o Ability to maintain accurate records, prepare reports, correct English usage, and maintain confidentiality

o Ability to construct grammatically correct reports using standard medical terminology

o Ability to use a computer keyboard and mouse up to 8 or more hours per day

o Fluent in English and Spanish highly desired

• Work Setting:

o Full-time, work from home position that can be located anywhere in the U.S.

o Ability to work normal business hours for assigned jurisdiction(s)

o Must have dedicated home office space that ensures privacy wi