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  • RN Case Manager (Telephonic)

    Honolulu, HI 96817

    Posted: 08/29/2023 Industry: Registered Nurse (RN) Pay Rate: Up to $85k

    Job Description

    Job Title: RN Case Manager (Telephonic)
    Location: Honolulu, Hawaii
    Pay: $60,000 - $70,000 per year
    Position Type: Full-time (Monday-Friday, half remote)

    Job Description:
    Express Healthcare Professionals is currently seeking a dedicated RN Case Manager (Telephonic) for a local insurance company in Honolulu. As an RN Case Manager, you will play a crucial role in providing telephonic case management (TCM) for medical care coordination and facilitating Early-Return-to-Work and Return-to-Work processes in a workers' compensation environment.

    Conduct telephonic case management by establishing timely and effective communication with injured employees, employers, and medical treatment providers.
    Document all pertinent information related to case management activities, ensuring accurate and complete records.
    Prepare various TCM reports, including Initial, Status, Activity Note, and Closure reports, within specified timeframes.
    Evaluate and assess treating physicians' treatment plans, diagnosis, symptoms, medical history, diagnostic testing, medications, therapies, and anticipated Return-to-Work date.
    Record timekeeping for all work output using JMC codes and submit time sheets for data entry daily.
    Develop comprehensive medical case management plans that focus on quality of care and cost-effectiveness, providing specific and action-oriented recommendations.
    Conduct thorough interviews with injured employees, employers, and medical providers to assess recovery needs and identify barriers to recovery.
    Analyze health records and medical reports to inform case management decisions.
    Manage injured workers' files, adhering to treatment guidelines and utilization criteria mandated by state guidelines and customer requirements.
    Communicate return-to-work capability with injured workers and providers, informing claim specialists and employers as needed.
    Monitor estimated length of disability based on established criteria and communicate this information to claim adjusters.
    Coordinate and facilitate referrals for providers, facilities, and durable medical equipment in an efficient and professional manner.
    Occasionally perform field-based task assignments upon request and approval.
    Negotiate services and equipment to achieve quality, cost-effective outcomes.
    Collaborate with departmental staff in a team-oriented environment, sharing knowledge and expertise.

    Job Requirements

    Bachelor of Science in Nursing (BSN) from an accredited school (preferred).
    Valid Hawaii State RN license.
    Minimum of 3 years of clinical RN experience.
    Current CPR/BLS and First Aid Certification.

    How to Apply:
    To apply for this exciting opportunity, please reply to this ad with your updated resume or call us at 808-792-7000. If you meet the requirements and are passionate about making a difference in the workers' compensation space, we look forward to hearing from you. Join our team and contribute to providing quality care and effective case management solutions in Honolulu!

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