Albuquerque, New mexico
Medical Case Manager (Bilingual) Job Opening in Albuquerque, New mexico - Integrion Group, a third party insurance administrator and risk management company is seeking an experienced, motivated, healthcare professional for a clinical position.
Integrion Group, provides an innovative challenging work environment, competitive benefits and compensation, as well as professional development opportunities. Integrion Group is an Equal Opportunity Employer and drug-free workplace that offers an environment with a strong emphasis on our customers and corporate values.
Position Summary : This position is responsible for handling assigned medical case management claims. The position will provide early intervention in the medical and return to work management processes for injured workers.
Essential Functions:
Contact the injured worker, employer, and medical provider as allowed by law to discuss diagnosis, plan of care, and work status.
Perform an initial interview with the worker to obtain his/her description of work injury, work history, medical history, treatment plan, etc.
Provide positive service and communication with the worker and employer to develop the best possible working relationship.
Document all activities in medical case management system, thereby maintaining the file. Coordinate all information with the assigned adjuster.
Formulate and activate a proactive medical case management plan.
Provide concise, comprehensive written or verbal communication to all relevant parties.
Maintain and actively work diary.
Perform initial and on-going clinical assessment and evaluation needed for treatment of work related injury and illness utilizing the Official Disability Guidelines.
Collaborate with all customers involved in the process to assess, plan, implement, coordinate, monitor and evaluate options and services required to achieve quality, cost-effective outcomes related to optimal medical improvement while minimizing lost time.
Job Qualifications:
Education and/or Education
RN preferred Bachelor?s Degree (BSN) from an accredited university or college in nursing. 2-4 years of clinical experience related to Trauma, Rehabilitation Therapy, Orthopedics, Workers? Compensation, Occupational Medicine and or Medical Surgical.
Specialized Knowledge, Licenses, etc.:
Current Jurisdictional Nursing License required.
Bi-lingual ? Spanish/English.
Excellent verbal and written communication and interpersonal skills required.
Ability to manage multiple and changing priorities.
Attention to detail, planning and documentation.
Discretion and confidentiality a must.
Knowledge of case management philosophy, process, outcomes and goals.
MS Office(Word, Excel, PowerPoint, Outlook)
Experience & knowledge in claims management, medical case management and record management communication systems and technology.
Values and Mission:
Adhere to values and mission by demonstrating Service Excellence, Trust, Ownership, ?One team? orientation and Boldness in thought and action.
Positive Attitude:
Develop and maintain a positive work environment by behaving and communicating in a manner that fosters good relations with clients, customers, co-workers and management.
Working Conditions:
Position requires regular driving on company business and requires that the employee maintain a satisfactory driving record, a reliable late-model vehicle, and a valid driver's license, proof of in-force automobile insurance coverage and authorization and release of driving records to permit the company to check the individual's driving record.
Integrion Group maintains general office conditions with light to moderate physical demands.
Employees of Integrion Group adhere to all safety rules and regulations including building security.
Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities.
Integrion Group maintains a drug free environment; drug testing prior to employment as well as upon a work related accident.
Exposure to VDT screens.
Job Type: Full-time
Required language:
Spanish
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