Medical Case Manager – Independent Contractor

I. Summary of Position:

Case Manager coordinates resources and creates flexible cost-effective options for catastrophically or chronically ill or injured individuals to facilitate quality individualized holistic treatment goals, including timely return to work when appropriate.

II. Essential Duties and Responsibilities:

• Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer and the referral source.

• Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation and outcome of individual’s progress.

• Evaluate individual treatment plan for appropriateness, medical necessity, and cost effectiveness.

• Facilitates care such as negotiating and coordinating the delivery of durable medical equipment and home health services.

• Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinates architectural assessment of patients home when required.

• Read extensively and stay current with medical terminology and the federal and state law relating to health care, Workers Compensation, ADA, HIPPA, FMLA, STD, LTD, SSDI, SSA.

• Utilize technology (computer, cell phone, fax and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPPA.

• Research medical and community resources for individuals with catastrophic or chronic diagnoses such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, burns, etc

• Documentation: Maintain accurate and timely records of care, assessments, and communications.

• Compliance: Ensure that all services are provided in accordance with legal, ethical, and organizational standards.

• Communication: Provide clear and consistent communication with appropriate parties ensure optimal care outcomes.

• Flexibility: Adapt to the needs of patients in different regions, understanding the unique healthcare challenges and resources available in each area.

• Collect, organize and analyze information about individuals through medical records, tests, interviews, and professional sources, to appraise their interests, aptitudes, abilities, and personality characteristics, for vocational and educational planning.

• Assist individuals to understand and overcome physical, financial, social and behavioral problems.

• Work with employers to assist in job placement providing supportive services including consultation on job modification.

• Perform other duties as assigned.

III. Job Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty, satisfactorily. The requirements listed below are representative of the knowledge, skill, and or/ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills and Abilities:

• Proven leadership skills.

• Excellent communication and interpersonal skills, with a focus on patient-centered care.

• Strong analytical and organizational skills, including the ability to multitask with attention to detail.

• In-depth knowledge of multi-software packages, most notably Microsoft Office Suite (mainly Word, Excel, PowerPoint, Outlook) and the Internet.

• Maintain a friendly, professional attitude at all times.

• Exercise initiative and be solution oriented, while keeping Management up-to-date on current situations or opportunities.

• Willingness to travel occasionally within the region as needed.

• Dependability and adaptability.

Education and Experience:

• Graduate of an accredited school of nursing.

• Current RN licensure in the state of operation. (Preferred)

• Certified Case Manager (CCM).

• Three or more years of recent clinical experience, preferably in the areas of trauma, psychology, emergency, orthopedics, rehabilitation, occupational health and neurology.

• Experience working with diverse populations and knowledge of the specific healthcare landscape in the assigned region.

• Bilingual skills are a plus.

Requirements:

• Must hold medical licensure or equivalent certification in practicing states

• Current professional liability insurance

• Valid driver's license

• Current auto insurance

Compensation:

• This is an independent contractor position, offering competitive compensation based on experience and region.