Clinical (Registered Nurse / RN) Case Manager - Full Time in Minneapolis, MN

Clinical (Registered Nurse / RN) Case Manager
Candidate Experience 2+ to 5 years of experience Management Experience Required - No
Minimum Education - Bachelor's Degree Willingness to Travel - Occasionally Candidate Screening Questions Is your candidate a nurse with behavioral health background? Clinical Case Managers examine Disability Pension and/or FMLA, STD (Short term disability), and/or LTD (Long term disability) claims from a medical and contractual standpoint and serve as a medical resource and consultant to case managers to assess functionality based on medical evidence. Review and evaluate disability claims to determine level of functioning based on knowledge of current medical standards of care and knowledge of the employer and the employee's job requirements, as well as the plan's definition of disability. Resolve inconsistencies in the level of functioning. Coordinate a strategy to determine true level of functionality. Review claims from a medical perspective to determine if medical evidence supports disability based on contractual provisions. Document disability status and assessment to include medical, contractual, and vocational information. Triage disability claims into appropriate claim management tracks (system-generated changes made during clinical case review). Act as medical consultant to Appeals Unit. Coordinate and monitor quality of Independent Medical Exams (IME's) and Functional Capacity Exams (FCE's). Coordinate internal physician consultant referrals by using supporting clinical resources and vocational resources. Identify barriers for employees to return to work as well as identifying appropriate (optimal) health care, rehabilitation and work to facilitate an early and safe return to work. Communicate effectively with employers, employees, and health care providers. Manage daily relations with assigned accounts and key contacts. Upon account requirements and upper management request, visit clients for new account implementation and maintenance of existing accounts. Seek and maintain current profession credentials, and engage in continuous medical education Qualifications Extensive medical knowledge. Strong investigative and analytical skills. Strong customer service skills. Strong written and oral communication skills. Strong organizational and time management skills. Ability to assess medical records. Work in team environment. Education and Experience