![]() Periodically participate and facilitate training programs and/or presentationsĪt least 3 years of current clinical experience in an acute care, orthopedic, rehabilitation industrial medical settings behavioral health settings, or current experience as a disability case managerĬlinical ability to assess claims with complex medical histories which may include claimants with subjective diagnoses, co-morbid conditions, etc ![]() Work closely with the STD/LTD Claims Team to identifying appropriate claim referrals and effectively assessing claims to ensure they reach the appropriate claim outcomeĬollaborate with Rehabilitation Case Managers Ability Analysts Employees, Policyholders, Healthcare Providers, and Vendors to facilitate and coordinate case management strategies to facilitate a potential Return to Work The successful hire will be responsible for the review of Long-Term Disability (LTD) and Short-term Disability (STD) claims with complex medical conditions referred for medical assessment clarification of limitations/ restrictions and/or case management Preferred Skills:Experience with facility-based and/or outpatient psychiatric disorder treatment center preferred Preferred Certifications:Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LICSW), Registered Nurse (RN), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), or Certified Case Manger (CCM) Preferred Education:Master’s degree in social work, psychology, nursing, or related human services field Skills:This job requires demonstrated ability to communicate, problem solve, and work effectively with people excellent organizational skills with the ability to manage multiple priorities simultaneously strong analytical skills knowledge of applicable state and federal regulations in depth knowledge of case management tools ability to take initiative and see tasks to completion excellent verbal and written communication skills skilled at establishing and maintaining positive and effective work relationships with coworkers, patients, and providers ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPPA) knowledge of office related computer applications Work Experience:Two to three years job related experience in mental health Periodic re-evaluation and revision of the plan as necessary over the life of the patient, which may include patient specific advocacy and/or review of utilization of servicesĮducation:Bachelor’s degree in social work, psychology, nursing, or related human services field or equivalent combination of education and experience Maintain and utilize a referral database, and coordinate care with other service providers involved in patient’s treatment plan Maintain ongoing dialogue with supervisor and other health providers to ensure effective implementation of health treatment plan ![]() Provide comprehensive assessment of the patient’s treatment needs and personal support systems Identifies all observation patients with observation alert sticker, reviews status no less frequently than daily, and communicates directly with the attending physician if severity of illness and intensity of service meet criteria for inpatient admission or when observation hours threaten to exceed 48 hrs.Reviews all new admissions daily against inpatient screening criteria and communicates necessary changes in status designation to ordering physician and Patient Access.Serves as liaison with Physician Performance Improvement (PPI) to ensure the reporting of quality indicators and care concerns. ![]()
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