Field Case Manager Resume Samples

4.5 (83 votes) for Field Case Manager Resume Samples

The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the field case manager job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

Craft your perfect resume by picking job responsibilities written by professional recruiters

Pick from the thousands of curated job responsibilities used by the leading companies

Tailor your resume & cover letter with wording that best fits for each job you apply

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

Resume Builder
CHOOSE THE BEST TEMPLATE - Choose from 15 Leading Templates. No need to think about design details.
USE PRE-WRITTEN BULLET POINTS - Select from thousands of pre-written bullet points.
SAVE YOUR DOCUMENTS IN PDF FILES - Instantly download in PDF format or share a custom link.

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

Create a Resume in Minutes
GH
G Hilll
Geo
Hilll
18578 Marks Square
San Francisco
CA
+1 (555) 331 6798
18578 Marks Square
San Francisco
CA
Phone
p +1 (555) 331 6798
Experience Experience
Houston, TX
Field Case Manager
Houston, TX
Ledner-Toy
Houston, TX
Field Case Manager
  • Meets with clients in their homes, work-sites, physician’s or hospital to provide management of services
  • Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities
  • Assists in the development of continued care plans as necessary to include patient education and prevention programs
  • The Medical Case Manager reports to the Team Manager, Case Management and has no direct reports
  • Provide therapy guidelines to manage physician expectations with respect to reimbursement
  • Work collaboratively with Personal Care Specialists, Wellness Case managers and Sales representatives
  • Work in the field and perform regular services calls with MD and/or Office staff
Los Angeles, CA
Optum Hospice Field Case Manager
Los Angeles, CA
Rippin Inc
Los Angeles, CA
Optum Hospice Field Case Manager
  • Interacting with other group members such as CNA's, LPN's, social workers and dieticians
  • Providing accurate and timely documentation of patient services to reflect plans of care
  • Providing accurate and point of care documentation of patient services to reflect plans of care
  • Interacting with other group members such as CNA's, Social Workers, Chaplain and Dieticians
  • Conducting admissions visits
  • Overseeing and participating in day to day clinical care of terminal patients and their families
  • Conducting regular visits at home or nursing facilities for a caseload of hospice patients
present
Phoenix, AZ
Senior Field Case Manager
Phoenix, AZ
Balistreri Group
present
Phoenix, AZ
Senior Field Case Manager
present
  • May assist supervisor/manager in review of reports, staff development
  • Local Field Case Management Travel entails 70% of work time​
  • Performs various duties including vocational evaluation, counseling, medical assessment and coordinate return to work
  • Proactively provides assistance to resolve client issues with regards to assigned physicians
  • Assistance and back up to the Associate Program Manager
  • Provide information and navigate patient through financial assistance and/or other client initiatives
  • Local Field Case Management Travel entails 70% of work time.​
Education Education
Bachelor’s Degree in Social Work
Bachelor’s Degree in Social Work
Adelphi University
Bachelor’s Degree in Social Work
Skills Skills
  • Strong attention to detail
  • Knowledge of workers' compensation and/or disability
  • Intermediate Ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
  • Intermediate Ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
  • Excellent problem-solving skills; ability to resolve issues effectively and efficiently
  • Effective organizational skills; attention to detail
  • Highly organized
  • Able to multitask efficiently and effectively
  • The ability to work effectively with minimal direct supervision
  • Ability to meet or exceed Performance Competencies
Create a Resume in Minutes

9 Field Case Manager resume templates

1

Field Case Manager SW Resume Examples & Samples

  • Bachelor's Degree with at least 2 years of relevant experience
  • Licensed Practical Nurse, licensed to practice in the state, with at least 4 years of relevant experience
  • Possession of a valid driver's license and access to an automobile
  • Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work
  • Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook
  • Bachelor's degree in Social Work, Sociology, Psychology, Gerontology or related field OR Licensed Practice Nurse
  • Experience working with geriatric population
2

Field Case Manager Resume Examples & Samples

  • Manage network participation, care with specialty networks, care with DME providers and transfers to alternative levels of care using your knowledge of benefit plan design
  • Examine clinical programs information to identify members for specific case management and / or disease management activities or interventions by utilizing established screening criteria
  • Active RN or LPN license in the state of Florida
  • Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
  • Case Management experience- experience with chart review and discharge planning
  • Valid driver’s license and dependable transportation necessary
  • This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
  • Previous Medicare/Medicaid Experience a plus
  • ICD-9 Coding experience
3

Field Case Manager Greater Orlando Market Resume Examples & Samples

  • Recommend services for Humana Plan members utilizing care alternatives available within the community and nationally
  • Identify potentially unnecessary services and care delivery settings, and recommend alternatives if appropriate by analyzing clinical protocols
  • Conduct admission review, post-discharge calls and discharge planning
  • Ability to travel 75% of the time throughout the Greater Orlando Market
  • Education: BSN or Bachelor’s degree in a related field
4

Field Case Manager Resume Examples & Samples

  • 1+ year of previous Home Care / Field experience
  • CT Registered Nurse (RN) license
  • CHHA / Medicareexperience
5

Field Case Manager Resume Examples & Samples

  • Six years of professional human services experience
  • Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite)
  • This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
  • AHCA Fingerprint Required
  • 701B Certification
  • Medication application (RFA) experience
  • Prior experience with Medicare & Medicaid recipients
  • Prior nursing home diversion or long term care case management experience
  • Road Warrior who enjoys traveling long distances
  • Previous experience with electronic case note documentation and experience with documenting in multiple computer applications/systems
  • Experience with health promotion, coaching and wellness
  • Knowledge of community health and social service agencies and additional community resources
6

Field Case Manager Resume Examples & Samples

  • Active RN or LPN license
  • Prior clinical experience preferrably in an acute care setting
  • Utilization Review Experience
  • Valid drivers license and/or dependable transportation necessary (variable by region)
  • Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10Mx1M
7

Field Case Manager Resume Examples & Samples

  • Be the single point of contact for the program with physicians
  • Assist MDs in completing Special Authorization (SA) forms, enrolment forms, prescription renewals, and other documentation
  • Provide ongoing updates to MDs on patient status
  • Provide therapy guidelines to manage physician expectations with respect to reimbursement
  • Work collaboratively with Personal Care Specialists, Wellness Case managers and Sales representatives
  • Provide program service explanation to MDs and/or Office staff
  • Promote the program with the marketing tools provided
  • Customize current program elements to meet the needs of assigned physicians: adjust based on in clinic and remote MD needs
  • Work in the field and perform regular services calls with MD and/or Office staff
  • Consult patient charts in order to effectively complete necessary paperwork to obtain coverage
  • Follow up with MD to insure patient status updates are shared
  • Responsible for providing customized monthly reports to physicians
  • Accurate and timely patient charting in CRM
  • Participate in scheduled physician meetings with Sales representatives
  • Identify areas for risk and foster proactive, continued quality improvement
  • Provides in service presentation to physicians
  • Adhoc duties as assigned
  • A Bachelor’s degree or registered nurse (RN) diploma
  • Related degree maybe considered (pharmacists, science degrees) or 2-4 years as Associate Field Case Manager or equivalent transferable skills
  • Requires a minimum of two (2) to three (3) years in public or private third party reimbursement arena or pharmaceutical sales experience, managed care, or clinical support, or related experience
  • Previous Case Manager experience an asset
  • Basic CCPE an asset
  • Demonstrated teamwork abilities
  • Ability to manage multiple tasks and priorities at once
  • Comprehension of medical terminology, Ability to read and interpret patient charts
  • Strong analytical skills including interpretation of regulation and legislation
  • Strong organizational skills, creative problem solving and results oriented
  • Strong time and project management skills and sense of urgency
  • Ability to analyze current enrollment volume by MD
  • Ability to analyze enrollment potential based on prescription volume of other biologics
  • Ability to engage with a physician and his/her staff as a trusted and well-informed medical counterpart
  • Must have a valid driver’s license and possess a car
  • Overnight Travel may be involved
  • Ability to attend Continuous Healthcare Education (CHE) events with HCPs, which may occur outside regular business hours
  • Can interact with multiple sales reps and district managers from the commercial team
  • Established relationships with Customers in a given territory, an asset
  • Knowledge of public, private and federal reimbursement an asset
  • Work with a keyboard
  • View a computer screen for long periods of time
  • Must be able to work from home and have a home based office space
  • Office space must accommodate equipment supplied by ABSG
  • Work environment must accommodate “work-with days” with District Manager
8

Field Case Manager Resume Examples & Samples

  • Available to travel within an assigned territory, some overnight travel may be required
  • Experience and background in various therapeutic areas is an asset
  • Normally requires a minimum of five (5) years in public or private third party reimbursement arena or pharmaceutical industry in sales, managed care, or clinical support,
9

Optum Hospice Field Case Manager Resume Examples & Samples

  • *There is a one-time Sign-On Bonus of $1,500 bonus for this position***
  • Conducting regular visits at home or nursing facilities for a caseload of hospice patients
  • Coordinating, assessing, and implementing patients' care
  • Providing accurate and timely documentation of patient services to reflect plans of care
  • Overseeing and participating in day to day clinical care of terminal patients and their families
  • Attending weekly interdisciplinary meetings
  • Interacting with other group members such as CNA's, LPN's, social workers and dieticians
  • Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of biohazard materials
  • Participating in a required on call (overnight) schedule that rotates throughout the team including weeknights, weekends and holidays as required
  • RN licensure (current, unrestricted) in the state location of position
  • 3+ years of clinical experience
  • Ability to perform physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of biohazard materials
  • Ability to participate in an on call rotation which currently includes 4-6 nights per week including weekends, weeknights and holidays
  • Computer proficiency with MS Office products including Word and Outlook
  • Hospice experience
  • Home care experience
  • Acute care experience
  • Long term care experience
  • Case management experience
  • Proficiency with electronic medical records (EMR) software
10

Senior Field Case Manager Resume Examples & Samples

  • Active, unrestricted RN license in state of New Jersey
  • 2+ years clinical nursing experience
  • High speed internet access in home
  • Experience with physical assessments
  • Computer proficiency to include the ability to use Microsoft Office
11

Optum Hospice Field Case Manager Resume Examples & Samples

  • Conducting regular visits at home or skilled nursing facilities for a caseload of approximately 12 to 15 patients
  • Conducting admissions visits
  • Providing accurate and point of care documentation of patient services to reflect plans of care
  • Interacting with other group members such as CNA's, Social Workers, Chaplain and Dieticians
  • Participating in a rotating on call schedule that may include week nights and weekends (as needed per requirement of the office)
  • 3 years of clinical experience
  • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
  • Ability to participate in an on-call rotation which consists of coverage 1x every other month or as needed
12

Optum Hospice Field Case Manager Resume Examples & Samples

  • Coordinating, assessing and implementing patients' care
  • Perform physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping and handling of biohazard materials
  • 2 years of clinical experience
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
13

Field Case Manager Resume Examples & Samples

  • Prior clinical experience preferably in an acute care clinical setting
  • This role is considered patient/provider facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
  • Experience working in a Skilled Nursing experience
14

Field Case Manager Resume Examples & Samples

  • RN; Registration with the Provincial College of Nurses
  • Minimum of 2 years of experience in Epilepsy Case management experience preferred
  • Knowledge of private and public reimbursement structure, systems, and process an asset
  • Excellent presentation skills
  • Intermediate knowledge of Microsoft Word, Excel, PowerPoint and other Office Programs
15

Field Case Manager Resume Examples & Samples

  • Be the single point of contact with physicians
  • Work collaboratively with sales representatives
  • Provide detailing/program explanation, in particular to MDs with low to no enrolment volume
  • Have the ability to manage multiple tasks and priorities at once
  • Customize current program elements to meet the needs of assigned top prescribing physicians: adjust based on in clinic and remote MD needs
  • Interpretation of patient charts in order to effectively complete necessary paperwork to obtain coverage
  • Ability to effectively describe medical history
  • Follow up with MD to insure patient has commenced drug treatment
  • Can be in contact with multiple sales reps and district managers
16

Field Case Manager Resume Examples & Samples

  • Reviews patient status and assists the prescribing physician to complete patient enrolLment, prepare Special Authorization (SA) petitions for public or private coverage by reviewing patient charts, assessing previous therapies and tests in order to complete the SA
  • Welcomes each patient to the program (conducts Welcome call) and captures required patient information
  • Ensures patient services are coordinated and tracked, according to KPI’s, resulting in expedited access to therapy
  • Follow up with patient the outcome of reimbursement navigation
  • The Senior Field Case Manager will also be assigned other duties and tasks as required from time to time
  • Background in business administration, sales and marketing an asset
  • Strong proficiency in Microsoft applications (Outlook, Word, Excel, Internet Explorer, PowerPoint)
  • Strong organizational skills, creative problem solving and results oriented; and
  • Superior verbal and written communication skills, interpersonal skills and attention to detail
17

Senior Field Case Manager Resume Examples & Samples

  • Customizes program elements to meet the needs of assigned prescribing physicians
  • Proactively assesses programs and makes suggestions to enhance outcomes and quality of service
  • Completes all relevant reports (time sheets, expenses, program specific reports etc.) as per specified timelines and as per required standards
  • Provides therapy guidelines to patients and physicians
  • Coordinates private and public coverage activity directly with insurers following program Standard Operating Procedures
  • Provide information and navigate patient through financial assistance and/or other client initiatives
  • Assist patient with pharmacy selection and coordinate drug delivery
  • Assist patient with coordination of therapy and ongoing patient monitoring
  • Reports Adverse Events / Severe Adverse Events following program Standard Operating Procedures
  • Participates in scheduled KOL physician meetings with Sales Representatives
  • Proactively provides assistance to resolve client issues with regards to assigned physicians
  • Attends scheduled Continuous Medical Education events and reports new activities
  • Provides in service presentation to KOL physicians in collaboration with the Sales Representatives on new program initiatives
  • With the manager, participate in the hiring and training process of new staff
  • Assistance and back up to the Associate Program Manager
  • Recommends corrective actions to program manager when project deliverables deviate from the work plan with the assistance of his/hers team members
  • A Bachelor’s degree or registered nurse (RN) diploma, advanced degree or specific practice management experience preferred
  • Normally requires a minimum of three (3) to five (5) years in public or private third party reimbursement arena or pharmaceutical industry in sales, managed care, or clinical support,
  • Pharmaceutical sales experience an asset
  • Strong coaching and training skills is an asset
  • Demonstrated teamwork abilities and customer service skills
  • Ability to make decisions using sound judgment
18

Field Case Manager Resume Examples & Samples

  • Knowledge of pharmaceutical distribution industry
  • Effective interpersonal and leadership skills
  • Effective organizational skills; attention to detail
  • Ability to consistently meet deadlines
  • Excellent problem-solving skills; ability to resolve issues effectively and efficiently
19

Field Case Manager Resume Examples & Samples

  • Minimum of 3 years case management experience (required for NCM role, preferred for all other areas)
  • Minimum 5 years clinical practice experience (required for NCM role only)
  • RN License required
20

Field Case Manager Resume Examples & Samples

  • Current active and unrestricted NY RN License
  • CCM preferred, not required, but will be expected to obtain CCM certification when requirements met
  • Willingness to travel up to 80% of each work day
  • Familiar with smartphone, applications, Outlook, Windows 7
21

Senior Field Case Manager Resume Examples & Samples

  • May assist supervisor/manager in review of reports, staff development
  • Reviews case records and reports, collects and analyzes data, evaluates client's medical and vocational status and defines needs and problems in order to provide proactive case management services
  • Performs various duties including vocational evaluation, counseling, medical assessment and coordinate return to work
  • Demonstrates ability to meet or surpass administrative requirements, including productivity, time management, quality assessment (QA) standards with a minimum of supervisory intervention. Facilitates a timely return to work date by establishing a professional working relationship with the client, physician and employer. Coordinates return to work with patient, employer and physicians
  • May recommend and facilitate completion of peer reviews and independent medical examinations by obtaining and delivering medical records and diagnostic films notifying patients
  • Manages cases of various product lines of at least 3-4 areas of service (Workers Compensation, Health, Short Term Disability, Long Term Disability, Auto, Liability, Third Party Administrator, Catastrophic, Life Care Planning). Specifically, the case manager should be experienced in catastrophic cases plus 2-3 additional types listed above
  • Renders opinions regarding case cost, treatment plan, outcome, and problem areas and makes recommendations to facilitate rehabilitation goals and return to work
  • May perform job site evaluations/summaries. Prepares monthly written evaluation reports denoting case activity, progress and recommendations in accordance with state regulations and company standards
  • May obtain referrals from branch claims office or assist in fielding phone calls for management as needed
  • Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for rehabilitation of the client
  • Travels to homes, health care providers, job sites, and various offices as required to facilitate return to work and resolution of cases
  • May meet with employers to review active files
  • Reviews cases with supervisor monthly to evaluate file and obtain direction
  • May perform other related duties as assigned
22

Field Case Manager Resume Examples & Samples

  • Demonstrates ability to meet administrative requirements, including productivity, time management and quality improvement standards, with a minimum of supervisory intervention
  • Renders opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate rehabilitation goals and return to work
  • Performs job site evaluations/summaries; prepares monthly written evaluative reports, denoting case activity, progress and recommendations in accordance with state regulations and standards
  • Facilitates timely return to work date by establishing a professional working relationship with the client, physician, and employer. Coordinate return to work with patient, employer and physicians
  • May recommend and facilitate completion of peer reviews and Independent Medical Examinations by obtaining and delivering medical records and diagnostic films as well as conferring with physicians both in person and on phone
  • May review files for claims adjusters and supervisors
  • Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for case management for the client
  • May obtain referrals from branch claims offices
  • Utilizing experience and medical resources interprets medical records and test results and provides assessment accordingly. Utilizes nursing process, case management standards of practice guidelines and Broadspire's Quality Improvement Guidelines in providing medical case management services
  • Meets monthly production requirements and quality assessment requirements to ensure a quality product
  • Travels to homes, health care providers, and various offices as required facilitating return to work and resolution of cases. (Approximately 70% of a Medical Case Manager's position is spent in local travel)
  • Reviews case with supervisor monthly to evaluate files and obtain directions
23

Field Case Manager Resume Examples & Samples

  • Evaluates members for case management services and determines appropriate level of care coordination/ management services for member
  • Completes a comprehensive assessment and develops a care plan utilizing clinical expertise to evaluate the members need for alternative services
  • Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities
  • Interacts continuously with member, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and current status. Assess the options for care including use of benefits and community resources to update the care plan
  • Maintains accurate records of case management activities in the Enterprise Medical Management Automation (EMMA) System using clinical guidelines
  • Coordinates community resources, with emphasis on medical, behavioral, and social services. Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues
  • Travel to inpatient bedside, member’s home, provider’s office, hospitals, etc required with dependable car. May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards. May require climbing multiple flights of stairs to a member's home, provider's office, etc
  • Required 2+ years of experience in clinical acute care
  • Preferred Other Managed care experience
  • Intermediate Demonstrated time management and priority setting skills
  • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
  • Required Licensed Registered Nurse (RN)
  • Required Other Maintain required contact hours to fulfill regulatory requirements
24

Field Case Manager Resume Examples & Samples

  • Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment
  • Conducts telephonic, face-to-face or home visits as required
  • Maintains ongoing member case load for regular outreach and management
  • Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for Molina members
  • May implement specfic Molina wellness programs i.e. asthma and depression disease managment
  • Assesses for barriers to care, provides care coordination and assistance to member to address concerns
  • Collaborates with RN case managers/supervisors as needed or required
  • Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
  • Local travel of up to 40% may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit
  • 1-3 years in case management, disease management, managed care or medical or behavioral health settings
25

Field Case Manager Resume Examples & Samples

  • Certification with the state Workers Compensation Court required
  • 1 year of worker's compensation experience is required
  • Minimum of three years' case management experience is highly preferred
  • One of the following national professional certifications is required: CRC, CDMS, CRRN, COHN, or CCM
  • Knowledge of laws and regulations governing delivery of rehabilitation services and knowledge. of disability & WC industry
26

Field Case Manager Resume Examples & Samples

  • Active Registered Nurse (RN) license required
  • Minimum of 3+ years case management experience strongly preferred
  • Minimum of 5+ years of total clinical practice experience as a Registered Nurse strongly preferred
  • Ability to travel within a designated geographic area for in-person case management activities
  • Bilingual proficiency a plus!
  • Knowledge of laws and regulations governing delivery of rehabilitation services preferred
27

Field Case Manager Resume Examples & Samples

  • An active and good standing RN license is required
  • Minimum of three years case management experience is preferred
  • 3-5 years clinical practice experience is required
  • Strong computer skills are required
28

Field Case Manager Resume Examples & Samples

  • Assesses and analyzes injured worker's medical and vocational status
  • Develops progressive plan of care to facilitate medical recovery and progressive return to work
  • Manages one-time task assignment or full field case management referral to meet with attending physician, injured worker and/or employer to clarify medical and/or vocational claim related information which could not be obtained through correspondence or telephonic attempts by claims team
  • Collaborates with members of the health care team to provide ongoing case management services
  • Acts as liaison for involved parties in the worker's compensation injury by communicating in person and telephonically with the patient/caregiver, attorneys, employer, claims examiners, telephonic nurse case manager, return to work specialists, vocational rehabilitation supervisor, provider(s), ancillary provider(s) and health care team
  • Monitors injured employee's progress towards appropriately established outcomes through continued assessment and evaluation
  • Coordinates necessary referrals, consultations, and therapeutic services for the injured employee
  • Completes the interview process with the patient/caregiver in the home, worksite, ancillary location or physician's office for current and ongoing assessments and evaluations
  • Assists in the development of continued care plans as necessary to include patient education and prevention programs
  • Testifies as needed to substantiate relevant case work or reports
  • Confers with medical treating providers concerning the course of care and treatment per clinical guidelines
  • Educates medical providers on appropriate disability and treatment guidelines as necessary
  • Supports the total performance management initiative
  • Works from home as needed
  • Knowledge of laws and regulations pertaining to rehabilitation and HIPPA
  • Knowledge of workers' compensation and/or disability
  • Excellent interpersonal and negotiation skills
29

Field Case Manager Resume Examples & Samples

  • Maintains regular contact with all parties involved to facilitate communication and to provide medical and vocational management and coordination services
  • Arranges for prompt and appropriate medical treatment of an injured worker by qualified providers (choice of providers as per regulations); Schedules appointments to avoid delays in treatment by primary care physicians, specialists or ancillary services
  • Assists the treating physician in developing a written treatment plan for the injured worker, including the identity and scope of treatment by any other providers to which referrals have been made. Work with the medical providers to track progress and to modify the treatment plan as necessary until maximum medical improvement is achieved
  • Obtains medical reports and required work status forms. Ensures all parties receive appropriate reports
  • Facilitate authorization/certification of procedures, diagnostic testing, physical therapy/occupational therapy and durable medical equipment as per regulations to ensure appropriate treatment is not delayed
  • Cooperates with the treating physician to obtain a full or conditional release to return to work before injury becomes a lost time claim; Work with the treating physician to update any conditions as medical treatment progresses
  • Assesses the injured worker and his/her support system and family; Makes appropriate referrals throughout the continuum of care including educational, financial, and psychological or other human services as indicated
  • Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return to his/her full pre-injury employment; The job must be consistent with any physical restrictions assigned by the treating doctor; Educates the employer on the tangible and intangible benefits of accommodating the injured worker to keep him in the work force
  • Where a return to work with the same employer is not possible, provide vocational services to the injured worker to identify vocational goals and develop an early return to work plan
  • Maintains constant contact with the adjuster assigned to the file through telephone calls, EMAIL and written reports. For each customer be aware of the limits of decision-making authority delegated by the adjuster to the case manager and respect these limits. Satisfy the documentation and reporting requirements of each customer
  • Makes appropriate use of Wellcomp physicians for adjuster support, peer-to-peer consultation and as professional resource; Make appropriate use of Wellcomp clinical and information systems staff to deliver exceptional service to direct & indirect customers
  • Organizes and review medical records to identify specific medical issues; Provides information and recommendations to appropriate parties
  • Acts as an advocate for the injured worker with all parties while maintaining the injured worker’s privacy and safety; Adheres to Wellcomp's confidentiality policies and procedures. Follows ethical, legal, and regulatory standards
  • Participates in the collection of outcome information and Wellcomp’s Quality Improvement process to determine the impact of case management activities on timely injury recovery, medical treatment, return to work, claim costs, and both injured worker and client satisfaction. The result achieves desirable outcomes for all
  • Maintains continuing education requirements per state license requirements. Maintains an updated and working knowledge of workers’ compensation and federal laws that impact the delivery of health care and return to work
  • Become proficient in the software used in the department
  • Contribute to the success of the company and its posture toward customer service by a positive and professional attitude and by understanding and responding to the needs of our direct and indirect customers; Follows ethical, legal, and regulatory standards
  • The Medical Case Manager reports to the Team Manager, Case Management and has no direct reports
  • The ability to work effectively with minimal direct supervision
  • The ability to plan and use time effectively
  • The ability to work as a member of the Wellcomp team
  • Keyboard typing and dialing of telephone require hand dexterity and the repetitive use of finger movement
  • Due to the nature of the position, sitting in a sustained position for prolonged periods may be necessary
  • Vision must be adequate to view the computer screen
  • This may include occasional air travel and overnight stays
  • Must have the ability and willingness to travel for task and/or field case management visits if within assigned geographic areas
  • Must possess a valid driver’s license; Must provide proof of insurance
  • Three or more year’s workers compensation case management experience or related field
30

Field Case Manager Resume Examples & Samples

  • An RN license is required
  • 2 years of Home Care/Hospice Care required
  • Minimum of three years case management experience preferred
  • Experience in using multiple online tools to capture care management plans, identify resources to support members and track activities
31

Field Case Manager Resume Examples & Samples

  • 10-25% of travel is required for member visits
  • 2 years of case management experience is preferred
  • 2 years of home care/hospice experience is required
  • CCM preferred
32

Field Case Manager Resume Examples & Samples

  • Case management/discharge planning experience; Required
  • 5 years clinical practice experience; Required (Medical Surgical, ICU, or Critical Care experience is Strongly Preferred)
  • 2 years of Home Care/Hospice Care; Required
  • Ability to travel within a designated geographic area for in-person case management activities; Required
  • Experience in using multiple online tools to capture care management plans, identify resources to support members