• NTT DATA
  • $106,465.00 -62,050.00/year*
  • New York, NY
  • Healthcare - Nursing
  • Full-Time
  • 48 Wall St

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Open need:



  • Direct hire

  • Workers' Compensation In-house Nurse Case Manager

  • Hiring 1

  • ASAP

  • NY, NY (zip 10005)

  • 4 days/week; 10 hour days; 40 hour work week

  • Training is provided


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NTT DATA Services takes the complexity out of modernizing technology for our healthcare clients. Interested? Apply today for this direct hire position in NY, NY (zip 10005).


We are seeking a Workers' Compensation In-house Nurse Case Manager who is personable, a quick study and customer service oriented.


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The selected candidate will be required to perform the following responsibilities as a vital member of our Client?s Claims Team:



  • Early intervention for medical case management on select workers? compensation claims

  • Provide case management in a workers? compensation environment. Conducts and documents an initial assessment with the injured worker, employer, and provider to collect information needed to collaboratively formulate a case plan

  • Develop appropriate treatment plans with a balance between quality of care and cost effectiveness that meets a universally accepted medical and disability duration guideline. (ODG/Presley Reed)

  • Adhere to URAC (Utilization Review Accreditation Commission) standards. Certification preferred but not required

  • Provide appropriate Utilization and Review of treatment under the NYS Medical Treatment Guidelines and recommends approval or denial by claims adjusters based on medical documentation, the guideline and nursing judgment

  • Work collaboratively with members of the Claims Team

  • Participate in file reviews, roundtables on complex and catastrophic cases

  • Provide documentation that is clear, concise and reflects strong technical and clinical knowledge with nursing assessments and action plans

  • Provide effective vendor management when assessing or managing cases

  • Serve as an informational and medical resource for the Claims Management staff

  • Provide prospective, concurrent and retrospective review services on cases as needed

  • Occasionally travel for direct face-to-face interaction with injured workers and providers


Qualifications



  • Employee must present documentation to verify minimum school educational requirement

  • Candidate must pass pre-employment screening which includes a background check

  • Candidate is subject to a 90-day evaluation period


Required Experience / Skills:



  • Five or more years of clinical nursing experience preferred

  • An Associate?s or Bachelor?s degree in nursing required; Registered Professional Nurse in NYS required; New Jersey license preferred

  • Certifications: CCM (Certified Case Manager) or COHN (Certified Occupational Health Nurse) or working towards certification status

  • URAC standards understanding and/or certification preferred

  • Demonstrate completion of the NYS WC Medical Treatment Guideline on- line training

  • Minimum three years of case management in the workers? compensation industry either with a TPA or vendor and a working knowledge of NY workers? compensation, disability and managed care law

  • Customer Focus: provides outstanding customer service, listens and maintains composure in all situations & involves others when appropriate; Interpersonal/Savvy - relates well with people with diverse backgrounds and can build appropriate rapport; Composure ? Is cool under pressure; does not become defensive or irritated in tough situations

  • Effective communication: Communication style that adjusts delivery to reach different audiences; strong verbal (phone) and written communication skills; ability to deliver difficult information

  • Excellent Decision Making and Problem Solving skills

  • Multi-tasking: Ability to adapt to changing priorities while maintaining a positive attitude

  • Time Management: Ability to coordinate services, tasks and reports timely

  • Valid state-issued driver?s license

  • Proficient in current Microsoft Office Suite programs

  • Work full time on site, with a team of adjusters, and work well with all levels in the organization and values diversity is a requirement


If hired, our customer offers employees the following:



  • Health insurance (with limited employee contribution)

  • 401K (with 100% employer match, up to 6% of salary)

  • Life and Dental insurance & paid Vacation, Personal and Sick time


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*Note: this is not a NTT Data position. We are assisting in recruitment but our customer is hiring direct for full-time.


Associated topics: business development, case manager, development, development manager, office manager, plan, project, program development, project management, resource development

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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