Hybrid Telephonic Medical Case Manager bei WCF Insurance

The Claims Operations department has an immediate opening for someone who can demonstrate the WCF values to join their team as a Telephonic Medical Case Manager. This is a full-time, exempt, hybrid position that works out of WCF's Sandy, Utah headquarters. This posting is open to internal and external candidates.

Responsibilities

• Assess, plan, implement, coordinate, and monitor medical services for injured workers.
• Communicate with injured workers, providers, adjusters, and other contacts to coordinate all medically approved services.
• Analyze medical records and clinical criteria to determine appropriate treatment and case direction.
• Serve as a medical resource to claims adjusters, vocational rehabilitation counselors, legal department and other WCF employees.
• Obtain accurate information and document the medical rehabilitation plan, progress, and recovery.
• Identify and recommend referrals to Field Case Management when appropriate.
• Demonstrate self-direction, accountability, critical thinking, analytical and research skills.
• Adhere to Utah Labor Commission rules and standards.
• Remain objective and professional when balancing conflicting needs of injured workers, providers, and claims adjusters.
• Provide excellent customer service and maintain diplomacy and confidentiality in all professional working relationships with internal and external customers.
• Maintain RN licensure, certifications and continue to enhance learning of industrial injuries.

Qualifications

• Graduate of an accredited RN program and current Utah license.
• Minimum of three years clinical experience or equivalent combinations of education and experience required (ICU, critical care, rehab, orthopedics, home health or occupational health).
• Experience in discharge planning, quality assurance, or case management, preferred.
• Knowledge of workers' compensation claims and medical recovery process.
• Strong communication (verbal and written), time management, computer, and negotiation skills.
• Efficient multi-tasking and clinical prioritization.

WCF Insurance offers an extensive compensation package. Benefits include Medical, Dental, and Vision insurance, company paid life insurance, 401K with a generous 6% employer match and additional benefits such as an Employee Assistance Program (EAP) and time off to volunteer in the local community. All employees earn 4 weeks of vacation in their first year. Expected salary for this position is $78,000 - $98,000 depending on experience, and education.

Internal candidates should have acceptable job performance, 6 months in their current position, and must notify their current supervisor that they have applied for the position.

Our People

WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive

WCF Insurance is an Equal Opportunity Employer

WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.