Senior Nurse Case Manager

Senior Nurse Case Manager

Excellence. Trust. Mutual Respect.

Do these words resonate with you? If so, Keep reading and apply below!These values of Builders culture create success in all we do. We strive to provide deeply supportive partnerships to our customers, agents, and each other.Builders is proud to be named one of the top workplaces USA with top marks in Company Direction, Employee Appreciation, Work-Life Balance, Leadership, and Compensation and Benefits. Our strong culture keeps us Built Strong in a forever-changing world, and our AM Best A Rating is evidence of our financial strength.

Summary of the role:Senior Nurse Case Manager is responsible for acting as liaison between all parties involved in the management of work-related injuries. Primary role is to control costs and length of disability through the monitoring of all medical aspects of the claim by implementing the nursing process which includes assessment, planning, coordination, intervention and evaluation.

What would be your day in the life at Builders?

Managing case load and provide initial contact on all assigned lost time files within 24 hours and provide complete early intervention report within 30 daysInputting pertinent data and recommendations electronically on all assigned cases and billsAssisting in the pre-certification process, recommending any diagnostic tests and procedures for medical review and medical necessityCoordinating and scheduling IME or second opinion appointments as needed, as well as all authorized medical treatments and appointmentsMaintaining contact with the injured worker, employer, and adjuster as often as needed, to ensure that the treatment plan is understood and improvement is being madeMaintaining communication between all parties involved in treatment plan (i.e. physician, therapist, etc.)Contacting and obtaining approval for injured worker contact on all represented cases as requested by the AdjusterConsulting with Supervisor on all cases that have been recommended for referral to a contract rehabilitation nurseMaking recommendations for referral to field case management on all cases meeting criteriaProviding medical updates after each appointment, including review of progress, change in work status and change in treatment planProviding early intervention on all assigned casesProviding monthly MR status reports addressing medical progress, treatment plan, RTW/Vocational issues and projected date of MMIAssisting in negotiating pricing for medical equipment, supplies and/or treatment as neededCoordinating return to work with adjuster and employerProviding recommendations based on the assessment of medical reports, evaluating for appropriate care and the claimant’s progress to recoveryKeeping abreast of any changes in procedures or handling of cases as well as Workers Comp. State laws.Ability to adhere to attendance guidelinesAdditional duties and projects as assigned

What skills will you need?

Bachelor's degree from an accredited college or university in NursingRegistered Nurse licenseCertification preferred - CRRN, CCM10 years of clinical nursing experience3 or more year of workers compensation case management experienceUtilization Review experience preferredAbility to evaluate situations and make appropriate recommendationsStrong verbal and written communication skillsAbility to work with internal and external customersStrong analytical, decision making and negotiation skillsSelf-motivated and flexible with ability to work independentlyStrong customer service, problem solving, interpersonal and organizational skillsStrong verbal and written communication skillsAbility to learn new software systems and programsAbility to multi-task, plan and focus on detailAbility to maintain the highest level of confidentialityAbility to interact with individuals at all levels, inside and outside of the companyComputer literate; advanced Microsoft Office skills

Let’s talk benefits!Competitive SalaryBonus StructureProfit SharingMedical, Dental, Vision InsuranceEmployer Paid Short Term DisabilityEmployer Paid Long Term DisabilityEmployer Paid Life InsuranceVoluntary Life Insurance401K with Company MatchPTO

About BuildersBuilders is a mid-sized mutual with remarkable strengths. Rated A by AM Best, Builders has forged rock-solid financial strength and a reputation for reliability and fairness in fulfilling our promises to customers. Kind, collaborative, and customer-centric, our experienced and passionate teams foster a rewarding atmosphere of excellence, trust, and mutual respect, meriting the “Culture Excellence” honors from Top Workplaces. Flexible and highly personal, our experts leverage deeply supportive partnerships with knowledgeable independent agencies to drive better services and protection for policyholders.

Our financial excellence, amazing people, and powerful partnerships build outstanding outcomes and peace of mind for our agents and their clients. This is what we mean by Insurance Built Strong®.