Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker’s successful and speedy return to work is good for people and good for Berkley’s insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology as a way to deliver the best outcome for injured workers and Berkley’s operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers’ compensation cases.
To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley’s operating units with reliable results, and reduced time and expenses associated with case management.
Responsibilities
As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers.
- Coordinate and implement medical case management to facilitate case closure
- Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
- Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
- Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
- Acquire and maintain nursing licensure for all jurisdictions as business needs require
- Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
- Document activities and case progress using appropriate methods and tools following best practices for quality improvement
- Coordinate job analysis with employer to facilitate return to work
- Engage and participate in special projects as assigned by case management manager
- Occasionally attend on site meetings and professional programs
- Review job analysis with physicians
- Foster a teamwork environment
Qualifications
- Located in one of the following time zones: Central, Mountain or Pacific.
Skills and Experience
- Minimum of 2-years of experience in insurance rehabilitation and medical/vocational rehabilitation preferred
- Minimum of 4-years medical/surgical clinical experience
- Exhibit strong communication skills, professionalism, flexibility and adaptability
- Possess working knowledge of medical and vocational resources available to the Workers’ Compensation industry
- Familiarity of the Dictionary of Occupational Titles (DOT) a plus
- Demonstrate evidence of self-motivation and the ability to perform case management duties independently
- Oral and written fluency in both Spanish and English a plus
Education
- Graduate of an accredited school of nursing and possess a current RN license, Bachelors of Nursing preferred
- Applicable state certifications and/or licensures in the state where job duties are performed
- Obtain other professional certifications as appropriate (CCM, CRRN, CDMS, COHN, CRC)
- Earn Continuing Education Units to maintain certifications and licensures
Travel Requirements
Domestic U.S. travel required (up to 10% of time)
Additional Company Details
The Company is an equal employment opportunity employer
Additional Company Details
We do not accept any unsolicited resumes from external recruiting firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Salary range: $80k-$90k
Additional Requirements
While performing the duties of this job, the employee is regularly required to be seated for sustained periods of time; be able to use a keyboard; pick-up, pinch, or twist objects; must be able to communicate information accurately; distinguish sounds at normal levels and be able to receive information orally. The employee is occasionally required to move about the office to accomplish tasks; reach in any direction; raise or lower objects or move objects from place to place; and hold onto objects. Occasionally, the employee may need to move or exert force up to ten (10) pounds. The employee is regularly required to operate a computer and other office equipment, including a phone, copier and printer.
Sponsorship Details
Sponsorship not Offered for this Role
Job Type: Full-time
Pay: $80,000.00 - $88,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid sick time
- Paid time off
- Parental leave
- Referral program
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Work Location: Remote