Field Case Manager Job Description

Field Case Manager Job Description

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Field case manager provides a weekly claims management forum to discuss workers compensation and disability cases with a multidisciplinary team.

Field Case Manager Duties & Responsibilities

To write an effective field case manager job description, begin by listing detailed duties, responsibilities and expectations. We have included field case manager job description templates that you can modify and use.

Sample responsibilities for this position include:

Communicate regularly with patients and families, with hospital team, and document regularly in required systems for outcome reporting
Participates in the collection of outcome information and Wellcomp’s Quality Improvement process to determine the impact of case management activities on timely injury recovery, medical treatment, return to work, claim costs, and both injured worker and client satisfaction
Completes all relevant reports (program specific reports, expenses, ) as per specified timelines and as per required standards
Proactive post discharge follow-up
Cuyahoga, Medina, Lake, Lorain and Geauga Counties
Completes all relevant reports (time sheets, expenses, program specific reports ) as per specified timelines and as per required standards
May recommend and facilitate completion of peer reviews and Independent Medical Examinations by obtaining and delivering medical records and diagnostic films conferring with physicians both in person and on phone
Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services
Utilizing experience and medical resources interprets medical records and test results and provides assessment accordingly
Travels to homes, health care providers, and various offices as required facilitating return to work and resolution of cases

Field Case Manager Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Field Case Manager

List any licenses or certifications required by the position: CCM, URAC, CIRS, CPR, COHN, CRRN, CDMS, BLS, WCCM, CMCN

Education for Field Case Manager

Typically a job would require a certain level of education.

Employers hiring for the field case manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Nursing, Education, Health, Science, Associates, Social Work, Management, Human Services, Sciences, Graduate

Skills for Field Case Manager

Desired skills for field case manager include:

Excel
Disability
Laws and regulations pertaining to rehabilitation and HIPPA
Workers' compensation
Private and public reimbursement structure
Systems
Process
Microsoft Word
Pharmaceutical distribution industry
Internet

Desired experience for field case manager includes:

Should include medical background we are looking for
Lower tier MDs should be offered only minimal services
Must be able to work from home and have a home based office space to accommodate equipment supplied by ABSG
Work from Home experience
Certified Case Manager (CCM) preferred but not required
Must have valid Drivers License without any restrictions

Field Case Manager Examples

1

Field Case Manager Job Description

Job Description Example
Our growing company is looking for a field case manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for field case manager
  • Obtains medical reports and required work status forms
  • Cooperates with the treating physician to obtain a full or conditional release to return to work before injury becomes a lost time claim
  • Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return to his/her full pre-injury employment
  • Maintains constant contact with the adjuster assigned to the file through telephone calls, EMAIL and written reports
  • Makes appropriate use of Wellcomp physicians for adjuster support, peer-to-peer consultation and as professional resource
  • Organizes and review medical records to identify specific medical issues
  • Acts as an advocate for the injured worker with all parties while maintaining the injured worker’s privacy and safety
  • Identifies the appropriate utilization of resources across the continuum of carMaintains patient/caregiver care plan compliance reporting
  • As needed, testifies to substantiate any casework or reports that may be deemed relevant in litigated cases
  • Meets weekly billing requirements (35-40 hours per week for full-time Case Managers)
Qualifications for field case manager
  • Requires a minimum of four (4) to five (5) years in public or private third party reimbursement arena or pharmaceutical sales experience, managed care, or clinical support, or related experience
  • Field Case Management or Home Health Care Experience preferred
  • Fluency in French, English and/or Cantonese/Mandarin may be required depending on program and geographic location
  • General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services
  • An active and good standing RN license for the state of Virginia is required
  • Must have strong clinical background with minimum of 3 years of RN experience working in adult care
2

Field Case Manager Job Description

Job Description Example
Our growing company is hiring for a field case manager. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for field case manager
  • Identify member needs and address these needs to remove any barriers in achieving optimal health care
  • Collaborate with members outpatient physicians
  • Conduct in-home assessments to assess members overall health needs, which includes medication reconciliation
  • Provide both on-going home visits and telephonic outreach
  • Provide member education on disease processes and the importance of good health
  • Identify community resources based on member need
  • Develop and monitor the member’s care plan goals for progress and outcomes
  • Accurately document members’ case management plans, authorizations, assessment, and levels of care
  • Assist with closing of any health care gaps to ensure member is receiving all preventative care
  • Collaborate with internal medical director and pharmacist when appropriate
Qualifications for field case manager
  • Preferred Other NCQA, EQRO accreditation experience
  • Intermediate Ability to effectively present information and respond to questions from families, members, and providers Strong oral and written communication skills including the ability to effectively present information and respond to questions from families, members, and providers the ability to relate effectively to upper management
  • CCM is preferred
  • Home Health, prior Workers Comp/Case Management/Rehab experience is preferred
  • Work from home but daily travel in and around Northern VA and Metro Washington DC area required
  • Valid PA RN license is required
3

Field Case Manager Job Description

Job Description Example
Our company is growing rapidly and is hiring for a field case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for field case manager
  • Conducts an evaluation of members needs & benefit plan eligibility
  • Uses holistic approach consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals & objectives
  • Interacts with members/clients telephonically & in person
  • Visit members with AARP supplemental insurance in their homes to complete assessments
  • Provide a complete continuum of quality care through close communication with members via in-person interaction
  • Identify gaps in care as members transition from a care facility back to their home
  • Conducts individualized clinical assessments to identify health concerns/needs
  • Helps member actively & knowledgeably participate w/ their provider in healthcare decision-making
  • Evaluates, prioritizes and reports on members plan of care/health outcomes in collaboration w/ the interdisciplinary care team
  • Presents cases at case rounds/conferences to obtain multidisciplinary perspective & recommendations to achieve optimal outcomes
Qualifications for field case manager
  • Workers compensation knowledge a bonus
  • Home health care experience a plus
  • Bilingual skills in Spanish (Must Speak English and Spanish fluently)
  • Job duties are performed in home office and out in the field
  • Knowledge of laws and regulations governing delivery of rehabilitation services and knowledge
  • MA/ BS / BA in Nursing or Associates Degree in Nursing from accredited school with Equivalent Work Experience and a CCM, CIRS, CRRN, COHN or other related designation or
4

Field Case Manager Job Description

Job Description Example
Our growing company is looking for a field case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for field case manager
  • Adheres to care mgmt
  • Manage a team of remote Field Care Managers
  • Will manage some remote team members, and will need to be able to travel within the state as needed
  • Completing the model of care requirements around Health Risk Assessments (HRA), High Risk Care Planning and Interdisciplinary Care Team meetings
  • Performing prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient settings
  • Educating and motivating Customers to participate in wellness programs
  • Supporting health promotion and disease prevention and care management services
  • Ensuring that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained
  • Managing caseload and coordinating all assigned cases
  • Do patient visits in both community and facility settings
Qualifications for field case manager
  • Minimum of 3 years’ experience in an acute care setting as a health care professional in a clinical area
  • Registered Nurse (RN) - Indiana (active, no restrictions)
  • Bachelor’s degree in Social Work with five years experience in Acute or Managed Care/ experience with Medicaid or Medicare populations
  • Associates Degree or Diploma in nursing is acceptable
  • Minimum 2 years clinical nursing background
  • Must be able to adequately operate a general computer, fax, copier, scanner, and telephone
5

Field Case Manager Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of field case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for field case manager
  • Make recommendations for care based on patients' needs
  • Contact the patient's Physician to request written orders to facilitate plan of care changes
  • Supervise, train, and evaluate Home Health Aides and Homemakers working with Pediatric Hospice patients
  • Do patient visits in both a community and facility setting
  • Develop and implement nursing plans of care and make recommendations for care based on patients' needs
  • Supervise, train and evaluate Home Health Aides and Homemakers working with Hospice patients
  • Meets with clients to conduct an initial assessment of their vocational and situational status in order to determine a required treatment plan and issue recommendations for maximum medical improvement
  • Meets clients as needed for in-home evaluations and/or meets clients at physician’s visits or therapist's appointments, work site locations, , in order to provide on-going case management services
  • Conducts on-site Job Analysis of client's pre-injury position assessment other positions requiring analysis
  • Responsible for communicating as required both in person and by telephone with all parties involved including clients, medical providers, attorneys, employers, insurance carriers
Qualifications for field case manager
  • Bilingual skills in Spanish highly preferred
  • Bilingual skills in Portuguese highly preferred
  • Current unrestricted Virginia RN license
  • Current RN License in good standing in the state of practice required
  • Must provide proof of personal automobile liability insurance with liability limits of no less than Five Hundred Thousand and No/100 Dollars ($500,000.00) per occurrence
  • Must be able to operate a vehicle and have the ability and willingness to travel for task and/or field case management visits within assigned geographic areas

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