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Workers Compensation Medical Case Manager Coastal South Carolina

Location:Charleston, SC
Employment Type:Full Time
Description:Key Risk, a member of Berkley Insurance Company, is a leading Southeastern workers compensation insurance company and third party administrator. Our home office is located in Greensboro, North Carolina with other offices in Charlotte, North Carolina; Columbia, South Carolina; Richmond, Virginia; Baltimore, Maryland; and Alpharetta, Georgia. We are seeking applicants for the position of Medical Case Manager for the Coastal South Carolina area. This position will be responsible for assessing, planning, coordinating, monitoring, evaluating and implementing options and services to facilitate timely medical care and return to work outcomes and will work out of a home office.
Duties:Coordinate and implement medical case management to facilitate case closure. Review and analyze medical records and assess data to ensure appropriate case management process. Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care. Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate. Document activities and case progress using appropriate methods and tools following best practices for quality assurance. Coordinate job analysis with employer to facilitate return to work.
Qualifications:• Graduate of an accredited school of nursing and possess a current South Carolina RN license. BSN preferred. • Three to five (3-5) years experience in insurance rehabilitation and medical case management preferred. Certification as a Certified Case Manager (CCM), a Certified Registered Rehabilitation Nurse (CRRN), and Certified Disability Management Specialist (CDMS), or a Certified Occupational Health Nurse (COHN) preferred. • Possess knowledge of principles of insurance, South Carolina workers compensation laws, disability systems, and the rehabilitation process. • Possess working knowledge of medical and vocational resources available to the workers compensation industry.

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