Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way.
Provides medical management to workers compensation injured employees.
Essential Duties & Responsibilities:
- Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers.
- Manage medical care in order to return injured employee to preinjury status. .
- Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling.
- Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program.
- Evaluates home care services and equipment and determines need for home modifications.
- Coordinates home care.
- Communicates with employers to determine job requirements of pre-injury occupation and to explore light-duty, modified, or alternate employment as necessary.
- Analyzes results of treatment and medical status and reviews incoming provider reports.
- Identifies suitable employment opportunities consistent with individual's medical limitations/capabilities, aptitudes, and interests to restore individual to maximum independence.
- Generates reports to referral source to communicate case status, findings, and recommendations.
- Generates correspondence to referral source, medical providers, injured worker and other parties involved in the rehabilitation process.
- Participates in case conferences over the telephone, and participates in internal and external training to enhance and maintain medical proficiency.
- Documents case management observations, assessment, and plan in system.
- Must maintain a case load to support at minimum 145 hours of billable or inventory of minimum of 72 files monthly with 95% Quality compliance expected.
Additional Considerations: Required:
- Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required.
- Active Registered Nursing license or equivalent within the state of practice or states in which CM is performed.
- Bachelor's degree preferred.
- Worker's Compensation experience is preferred.
- Certification in related field preferred.
- Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
- Demonstrates good written and oral communications, organizational and leadership skills.
- Computer literate. Demonstrates good time management skills. Self-starter.
U.S. Eligibility Requirements:
- Interested candidates must submit an application and resume/CV online to be considered
- Must be 18 years of age or older or must demonstrate legal capacity to enter a contract
- Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
- Must have unrestricted work authorization to work in the United States. For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
- Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure
Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.
Gallagher believes that all persons are entitled to equal employment opportunity and does not discriminate against nor favor any applicant because of race, sex, color, disability, national origin, religion, creed, age, marital status, citizenship, veteran status, gender, gender identity / expression, actual or perceived sexual orientation, or any other protected characteristic. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant with a disability, unless the accommodation would impose an undue hardship on the operation of our business.