Case Manager at Genex Service LLC

Posted in Management 11 days ago.

Location: Durham, North Carolina





Job Description:


Genex Service LLC


Case Manager

US-NC-Durham

Job ID: 21-12521
Type: Regular Hire
# of Openings: 1
Category: Case Management
Mitchell International

Overview

The Enlyte Family of Businesses

Mitchell | 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.



Responsibilities

This is a full time, remote position with regular local travel (70%) required in the Durham, North Carolina 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.

Home Office Requirements:


  • Requires DSL, fiber or cable internet connection from home. 1 Mbps preferred or better.

  • Home office must be HIPAA compliant.

PI150211460


More jobs in Durham, North Carolina


Blue Cross and Blue Shield of North Carolina

Sizewise

Ecoplexus
More jobs in Management


Salesforce.com

Salesforce.com

Salesforce.com