Nurse Case Manager

Date: May 12, 2019

Location: Rochester, NY, US, 14604

Job requisition: 13553
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Division or Field Office:

Claims Division

Department of Position: Workers' Compensation Dept 

Work from:

Home in New York

 

At Erie Insurance, you’re not just part of a Fortune 500 company; you’re also a valued member of a diverse and inclusive team that includes more than 5,000 employees and over 2,200 independent agencies.  Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia.  To attract and retain the best talent, we reward our team members with competitive salaries and a very generous benefits package.

 

Position Summary

Regularly exercises independent discretion and judgment in the coordination and management of the medical and disability process. Provides medical and rehabilitation consultation and education to claims personnel.

Erie Insurance, a Fortune 500 company, is seeking a full time Workers’ Compensation Nurse Case Manager.  This is a work from home position, servicing and ideally residing in New York and surrounding areas.  Erie Insurance offers a competitive salary and excellent benefits including a pension.

We are willing to train the right candidate; however, Workers’ Compensation case management experience is preferred.  Excellent communication and writing skills are strongly preferred.  

You will be joining a team of experienced professionals who will work with you to maximize this opportunity.

Duties and Responsibilities

  • Coordinates the injured workers' medical treatment to ensure both cost effective and medically appropriate care is provided.
  • Identifies inappropriate, experimental, overutilization or costly medical treatment.
  • Facilitates the return to work process by acting as a liaison between the insured, medical provider, injured worker and the claims handler. Prepares job analyses and obtains medical clearance for return to work.
  • Provides the claims handler with appropriate disability timeframes through the utilization of the Official Disability Guidelines.
  • Questions the causal relationship between the treatment and injury claimed.
  • Coordinates treatment plans for cases involving catastrophic injuries and complicated medical conditions.
  • Assists in identifying and evaluating providers and managed care vendors.
  • Oversees Vocational Rehabilitation activities in collaboration with the claims handlers.
  • Proactively manages and controls expenses through utilization of Erie's cost containment vendors.
  • Prepares medical cost projections and makes reserve recommendations upon request.
  • Provides medical education and guidance to claims handlers on complex files.
  • Maintains current knowledge of medical and rehabilitation trends.
  • Competencies

    Ability To Learn And Follow Procedures

    Ability to Manage Complexity

    Decision Making

    Detail Orientation

    Developing And Maintaining Relationships

    Information Management Skills

    Interpersonal Communication

    Job-Specific Knowledge

    Planning And Organizing

    Problem Analysis

    Service orientation

    Time Management

    Qualifications

    High school diploma, or GED, required. Current unrestricted Registered Nurse (RN) license in the state where the position is based and other assigned states as required by law. Bachelor of Science in Nursing (B.S.N.) and Certified Case Manager (C.C.M.) preferred. Three years experience in case management involving workers' compensation claims preferred. Five years clinical nurse experience with a preference for previous Orthopedic, Emergency Room, or Critical Care experience preferred. Incumbent must live in region assigned unless a change is approved by the company. Valid driver's license and good driving record required.

    Physical Requirements

    Lifting 0-20 lbs; Occasional (<20%)

    Lifting 20-50 lbs; Occasional (<20%)

    Lifting Over 50 lbs; Occasional (<20%)

    Driving; Occasional (<20%)

    Pushing/Pulling; Occasional (<20%)

    Manual Keying/Data Entry; Frequent (50-80%)

    Climbing; Rarely


    Nearest Major Market: Rochester

    Job Segment: Claims, Workers Compensation, Insurance, Human Resources

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