RN, Nurse Case Management, Risk Management - Lakeland

Description

The purpose of this position is to provide medical evaluation, clinical management, and coordination of medical services for Publix associates that have sustained on-the-job injuries. The Nurse Case Manager is responsible for the evaluation of the medical necessity of recommended services, coordination of those services, and monitoring of these services to facilitate timely return to work within nationally accepted disability duration guidelines. The Nurse Case Manger monitors the ongoing treatment plan to ensure treatment is appropriate and recovery objectives are achieved. The RN Case Managers are required to acquire and maintain licensure credentials and requirements in all of the states in which Publix conducts business.

The impact this position has on Publix is that the RN Nurse Case Manager is critical to the process of a timely and accurate return to work for injured associates. This has a direct productivity/financial impact on the departments in which the associates work. This process directly impacts the medical and indemnity costs of the workers compensation claim.

The responsibilities listed on this position analysis are not intended to be all-inclusive and additional responsibilities may be assigned as needed.

Responsibilities include:

• conducting ongoing clinical case management and evaluation of the medical care for associates who have sustained on-the-job injuries
• monitoring of prescribed medications
• collaborating with medical provider and claims team to identify and coordinate appropriate diagnostic services and specialist provider referrals
• monitoring/or clarification of provider documentation
• identifying the best vendor sources for medical supplies and other clinical services that provide the best outcome and value

Additional Information

Your application may have additional steps that you will need to complete in order to remain eligible for consideration. Please be sure to monitor your email, including your spam folder, on a daily basis for critical, time-sensitive emails that could require action within 24-48 hours.

Please do not use your Publix email address when applying. Once your application has been successfully submitted you will receive a confirmation email.

For this position, Publix does not and will not file a petition or application with the USCIS or Department of State on behalf of any noncitizen for any immigration-related benefit to work and/or to continue to work in the United States, e.g., an H-1B or TN petition or permanent residence.

Required Qualifications

• Associate's Degree in Nursing (ADN) and active Florida RN license.
• Must be unencumbered to secure licensure in the states in which Publix operates.
• Minimum of three years of clinical experience in hospital, clinic or institutional setting
• Basic Life Support. Current unrestricted Florida licensure.
• Required to successfully complete CCM Certified Case Management and pass the national certification exam within 2 years of employment.
• Excellent verbal and written communication skills
• Excellent negotiation and problem-solving skills
• Ability to multitask with several projects and files with minimal direct supervision
• Basic skill level in Microsoft Office programs including Word, Excel and Outlook

Preferred Qualifications

• Bachelor of Science in Nursing (BSN)
• Some experience in case management, utilization review and/or Workers Comp
• CCM (Certified Case Manager) or COHN (Certified Occupational Health Nurse)
• Knowledge of application of medical protocols and guidelines
• Knowledge of the Workers Compensation process and requirements for Medical management in the multiple states in which Publix operates
• Advanced skill level in Risk Master
• Intermediate skill level in Microsoft Office programs including Word, Excel and Outlook, ODG Guidelines Special Program and multiple clinical vendor information portals