Nurse Consultant Telephonic Case Management
About this role
How you'll make an impact
Provides medical management to workers compensation injured employees. Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers. Manage medical care in order to return injured employee to preinjury status. . Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling. Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program. Evaluates home care services and equipment and determines need for home modifications. Coordinates home care. Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary. Analyzes results of treatment and medical status and reviews incoming provider reports. Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence. Generates reports to referral source to communicate case status, findings, and recommendations. Generates correspondence to referral source, medical providers, injured worker and other parties involved in the rehabilitation process. Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency. Documents case management observations, assessment, and plan in system. Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected.
About You
Required: Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required. Active Registered Nursing license or equivalent within the state of practice or states in which CM is performed .
Preferred: Bachelor's degree preferred. Worker's Compensation experience is preferred. Certification in related field preferred.
Behaviors: Demonstrates adequate knowledge of managed care with emphasis on use of criteria , guidelines and national standards of practice. Demonstrates good written and oral communications, organizational and leadership skills. Computer literate. Demonstrates good time management skills. Self starter.
Compensation and benefits
At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.
- Competitive compensation
- Comprehensive benefits programs designed to support your well-being
- Career development opportunities and ongoing learning
- A collaborative, people-first culture with accessible leadership
- The opportunity to do meaningful work with global reach and local impact
At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.
Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)
Company at a glance
About Gallagher Bassett
We are the leading provider of claims and risk management services, helping people and companies prevent, manage and overcome the impact of risk. Our team of experienced professionals understands the nuances of your business and always delivers the outcomes that matter most to your organization.
Our story is one of strategic decision making, innovation, commitment to quality, and delivering excellent service. With these, Gallagher Bassett provides a unique suite of claims management and related consulting and technical services.
Gallagher Bassett introduced the Third-Party Claims Administrator (TPA) model to the local insurance industry. As pioneers in this fast-growing sector, we continue to set the benchmark for quality, customer service, and TPA systems across all insurance sectors.
We have operations in the United States, Australia, and the United Kingdom.
Being part of a global organization gives us an advantage in technology, processes, personnel, and consulting services. This combination of global reach and local market expertise enables us to quickly and accurately assess any situation and provide an optimal solution. Our clients can rest assured that we fully understand their needs and are equipped to act whenever, wherever, and however required.
Top Benefits
- Competitive compensation
- Comprehensive benefits programs
- Career development opportunities
- Ongoing learning
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