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Location

Ashburn, VA | United States

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Job description

RN Case Manager (Field Nurse):

The RN Case Manager (Field Nurse) for the Nurse and Vocational Rehabilitation Case Management Services (NVRS) program will report to a Regional Team Lead and will work with the rest of the Nurse and Vocational Rehabilitation Case Management Team to deliver expert, quality services and supports to our Department of Labor customer and the injured workers (IWs) the program serves.

The RN Case Manager (Field Nurse) provides case management under the Nurse and Vocational Rehabilitation Case Management Services (NVRS) Contract, which supports the Office of Workmen’s Compensation Programs (OWCP) above and beyond the disability claims management process managed by a claims examiner by providing intensive and immediate intervention early in the disability period, assist with the medical management of disability claims, and assist with the provision of vacation rehabilitation services. The RN Case Manager (Field Nurse) assists in the medical management of disability claims and helps IWs to coordinate medical care and return to work. The RN Case Manager (Field Nurse) uses professional nursing knowledge, assessment skills, and technical skills to accomplish this. Support is primarily delivered remotely, but in person attendance at key medical appointments, home visits, and work site visits may be required when there are complications in care and to ensure continuity and forward progress to return to work.

Responsibilities include, but are not limited to:

• Assess the IW’s current medical status, the anticipated duration of disability from work, and active treatment plan to ensure appropriate measures are in place to facilitate recovery and a timely return to work.
• Work with the medical providers to obtain appropriate treatment plans and coordinate recommended and approved medical care. (referrals to specialists or other health care providers, diagnostic testing, surgery, home care services, etc.).
• Review claimant eligibility for services, pending medical authorizations, and submit medical authorization requests, to assist providers and IWs in requesting authorization for medical services in a timely manner.
• Assess the IW’s response to ongoing medical treatment, anticipated duration of disability from work, and medication management to provide recommendations or alternative treatment options to the physician and the Government to facilitate medical recovery and a timely return to work.
• Collaborate with the EA to identify light duty work accommodations and/or barriers to the return- to-work efforts and coordinating the return to work in a timely manner.
• Identify cases suitable for a referral for a Second Opinion medical examination and prepare cases for a referral for a Second Opinion medical examination. Prepare cases for a Second Opinion medical examination by completing file review, preparing the Statement of Accepted Facts (SOAF) and preparing appropriate questions for the examining physician.
• Identify any physical limitations or other barriers affecting the IW’s adaptability to work duties, coordinating in the transition of the IW’s return to work, monitoring success of return to work, and when needed via participation in on-site employer visits and follow up monitoring.
• Communicate promptly to the Government all case milestones/activities that require action (i.e. return to work, work stoppage, recurrence of symptoms, unrelated medical issues, etc.).
• Make recommendations for Vocational Rehabilitation and working cooperatively with rehabilitation counselors when appropriate.
• Maintain case records in the Government’s system of record.
• Draft routine correspondence and interim communication, and all required work products/reports. (Initial Monthly Report, FN Monthly Case Management Reports, and Closure Reports, Second Opinion Prep Packets).
• Adhere to all timeframes for the delivery of case management services.

Minimum Skills and Qualifications:

• RN with active, unrestricted license
• 2+ years adult medical/surgical nursing experience AND 2+ years case management experience in the worker compensation arena OR 1+ years adult medical/surgical nursing experience AND 3+ years case management experience in the worker compensation arena.
• Additional certifications preferred: COHN, CCM, CIRS/CRRN, CDMS, or ANCC/ANA.
• FECA nurse intervention program experience (within the last 5 years) preferred.
• Must possess strong computer skills in MS Office, including Excel, Word, Teams.
• Ability to type 45 wpm.

Pay Rate: $48.50- $62.00 Per hour 

Remote work, from home office. Occasional travel, as deemed necessary and approved when there are complications in care and in-person support is critical to ensure continuity and forward progress to return to work.

This is a full-time position.

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Salary