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Position Summary:
Develops an effective system of communication with physicians, patients, employers, insurance carriers, and rehab consultants in order to monitor treatment progress and outcomes, and to ensure appropriate, timely, cost-effective, and seamless treatment delivery for patients receiving treatment for work related injuries.
Qualifications:
EDUCATIONAL REQUIREMENTS
Bachelors Related Field or Associates Nursing or College Diploma Nursing or three years experience in Worker's Compensation delivery systems is valid substitution for academic achievement.
CERTIFICATION & LICENSURE REQUIREMENTS
Applicable Illinois Licensure for Registered Nurse or Licensed Practical Nurse if educational background is nursing.
EXPERIENCE REQUIREMENTS
Three (3) years Related Field
SKILLS AND KNOWLEDGE
Extensive and practical knowledge base re: the Illinois Worker's Compensation Act and its provisions; employer and insurance carrier issues/needs/expectations; counseling and problem solving skills with individuals at a variety of levels. Requires knowledge of medical terminology; strong organizational skills, effective communication and interpersonal skills; ability to think on one's feet; ability to work effectively and confidently with patients, physicians, employer representatives, insurance adjusters, and Carle staff. Ability to effectively prioritize and clearly document communications and provide consistent, timely follow-through. Ability to work independently as well as collaboratively and to function as part of a team.
Essential Functions:
- Arranges/coordinates case conferences as necessary regarding occupational rehabilitation clients.
- Contacts payers to obtain prior authorization for services; documents and conveys payment.
- Develops and implements a comprehensive, effective system of communication with physicians, employers, insurance carriers, rehab consultants, attorneys, and counseling of patients.
- Educates staff regarding Worker's Compensation and return-to-work issues.
- Evaluates cases and assists providers with treatment plans.
- Monitors progress/outcomes (in treatment) to ensure appropriate, timely, cost-effective, seamless treatment delivery for patients receiving treatment for work related injuries and those referred for rehabilitation.
- Schedules functional capacity evaluations, functional abilities assessments, work conditioning baseline evaluations, and work conditioning.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.
Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.