100,000's of Government Jobs

Search Government Jobs

Job Field: Legal Jobs
Location: Glendale, CA
Salary: $Not stated

JOB SUMMARY:

---

</tr>
<tr><td valign="top" width="450"><b>The RN/Disability Clinical Case Manger does
receive claim referrals and assesses
medical/disability status and reports within
quality assurance time frames.
A typical day will include
Monitors medical progress of claimants and reports
on and plans for deviations from the normal
recovery process/length of disability.
Evaluates timely activity and case development of
an effective medical plan with the most
appropriate outcome.
Routinely evaluates case studies to identify
trends, issues, and concerns.  Makes any necessary
modifications.
Participates directly in customer service calls,
visits, pre-sales, installations, and renewals.
Supports CIGNA Group Insurance initiatives for
quality improvement, change, growth, and
excellence in business practices.
Understands and is able to articulate claimants
perspective
Facilitates relations with and between Claim
Examiners, business partners, and customers to
develop claim strategies, reduce the total cost of
disability in all forms and implement improvement
opportunities.
Collaborates with health care providers and
ill/injured employees to promote accountability
for the appropriateness and status of treatment
plan and length of disability.
Acts as an advocate for injured/ill individuals
through the assessment, planning, coordination,
collaborating, evaluating, and communication of
objective information regarding the medical status
and state of well being.
Acts as a medical resource person for staff
provides educational opportunities for staff
through training, inservice, and sharing of
resources on one-on-one or group forums, whichever
is most efficient and effective.
Qualifications
Ideal candidate will offer
Licensed Registered Nurse with current licensure
in state of residency and state of employment.
License must be current and without standing or
pending censure by any state.
A minimum of 5 years clinical experience with
strong clinical background in at least one or more
of the following
Medical/Surgical Nursing Occupational Health
Nursing
Rehabilitation Nursing Psychiatric Nursing
Critical Care Nursing Public Health Nursing
Certifications in Case Management or Disability
Management Specialist.
Ability to function in a team environment
Strong skills in medical assessment/medical record
review.
Excellent Excel and Word processing skills,
ability to type proficiently, strong PC skills
Excellent organizational skills to facilitate the
coordination and completion of multiple and varied
requests
Written and oral communication skills that allow
clear and concise presentation of conclusions and
recommendations to a variety of audiences.
Self-starter with the ability to be effective in a
large, complex and highly matrixed organization.
Ability to focus on both the details and big
picture at the same time
Ability to convey empathy via telephonic
interaction

KEY REQUIREMENTS:

---

None Not stated