Senior Field Case Manager 1 Details

Senior Field Case Manager 1

Genex Services - Modesto, CA

Employment Type : Full-Time

Company Overview:The Enlyte Family of BusinessesMitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.Job Description:This is a Full-time, remote position with regular local travel (70%) required in the Modesto, CA area.
The Field Case Manager is responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process. Working as an intermediary between carriers, attorneys, medical care providers, employers and employees, you will closely monitor the progress of the injured worker and report results back to the employer and insurance carrier. This will ensure appropriate and cost-effective healthcare services leading to a medically rehabilitated individual who is ready to return to an optimal level of work and functioning. You will:

• Use clinical skills to help coordinate the individual’s treatment program while maximizing cost containment.
• Serve as an intermediary to interpret and educate the individual on his/her disability, and the treatment plan established by the case manager, physicians, and therapists.
• Facilitate treatment between providers and the worker.
• Provide resources for claims personnel when needing providers in certain locales.
• Partner with employers determining modified work.
• Accurately document meeting Best Practices timeframes.
• Report billing hours in accordance with case activity and billing practices.
• Follow specific account instructions.
• Demonstrate professionalism within the work place and in dealing with injured workers.

Qualifications:

• Licenses or Certifications: Current, unencumbered Registered Nurse license required in the resident state; CCM, COHN, CDMS, or CRRN preferred.
• Minimum of one year clinical experience in a hospital setting.
• Worker’s compensation or disability management experience is highly desired but not required.
• Previous field case management experience is preferred but not required.
• Requires excellent time management and organizational skills.
• Spanish speaking a plus.
• Must have reliable transportation.
• Knowledge of basic computer skills including Excel, Word, and Outlook Email.
• Must have local unencumbered driver’s license and proof of automobile insurance.
• Written Abilities: Proficient grammar, sentence structure and written communication skills are required.
• Fully vaccinated against COVID-19, this role requires that you attend appointments in healthcare facilities that have COVID-19 vaccine mandates in place. Please note that fully vaccinated means 14 days have passed since receiving: the second dose of the Moderna/Pfizer vaccine or one dose of the Johnson and Johnson vaccine.

Home Office Requirements:

• Requires DSL, fiber or cable internet connection from home. 1 Mbps preferred or better.
• Home office must be HIPAA compliant.

Benefits : We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. In addition to salary and benefits, we also offer our Field Case Managers: a Case Management bonus, paid travel time, mileage reimbursement and monthly phone reimbursement. The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.