[Hiring] Field Nurse Consultant Workers' Compensation @Zenith Insurance Company

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

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Role Description

Conduct in-person and telephonic assessments of injured workers to evaluate injury status, treatment progress, functional capacity, and barriers to recovery.
Attend medical appointments as needed to facilitate communication between providers, injured workers, and claims stakeholders.
Review medical records, diagnostic studies, and treatment plans to assess appropriateness, progress, and consistency with evidence-based guidelines.
Identify treatment delays, non-adherence, psychosocial risk factors, and other obstacles impacting recovery.
This is a remote role with a preferred location around the Fresno, Salinas, Monterey, and Modesto area in California.
The selected candidate will be provided with a company car for travel.

Communicate with injured employees, medical professionals, claims staff, and employers timely and regularly to obtain information necessary to make sound medical assessments regarding diagnosis and prognosis.
Assess injury severity, extent of disability, treatment plans, functional abilities, and physical job requirements to establish target return to work plans and/or strategy to manage future medical exposure.
Direct treatment to appropriate panel and network providers, effectively negotiating treatment plans in compliance with Labor Code statutes and company standards.
Utilize and manage resources appropriately, including external field case managers, vendors, UR/peer review, and medical director.
Respond to various written and telephone inquiries timely regarding status of case.
Consistently and accurately document interventions, rationale, and recommendations in the Zenith system, utilizing the appropriate templates, and following Zenith guidelines, as indicated.
Facilitate earliest appropriate return to work release and coordinate return to work efforts with all parties, as appropriate.
Facilitate Maximum Medical Improvement and discharge from care.
Educate claims staff, employers, and other Zenith staff on medical issues/guidelines, within corporate guidelines.
Work productively and harmoniously with others on a consistent basis.
Respond positively to direction and feedback on performance.
Consistently maintain professional and appropriate demeanor.
Perform other duties/projects as assigned.

Regular and reliable attendance is required; must be able to work at least 37.5 hours per week, Monday through Friday, and be available for extended hours as situations arise.
Position may require extensive travel and remote working conditions, or overnight travel.
Must be available to work catastrophes (CAT) requiring travel to CAT sites with varied claims responsibilities and for extended periods of time beyond the typical work week.

Must be a Registered Nurse or similar.
High School Diploma or equivalent combination of education and experience required.
Bachelor’s Degree or equivalent combination of education and experience preferred.
Certified Case Manager (CCM) certification is a plus.

3+ years of experience maintaining a current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law.

Pursues continuing education as it pertains to maintaining RN licensure and certification, relating to workers’ compensation and utilization review practices.
3 years recent experience working remotely either in a telephonic or field case management role with a preference in workers’ compensation.
3 to 5 years clinical practice with experience in orthopedics, neurology, or occupational medicine preferred.
Possesses or pursues additional professional certifications; such as CCM, CDMS, CIRS, CRRN or COHN.
Strong written and verbal communication skills in order to effectively communicate with injured employees, medical professionals, employers, claims staff, and others.
Good negotiation skills to successfully establish target return to work dates and manage medical and disability treatment plans.
Proficient in basic computer skills, especially Microsoft Outlook and Office.
Comfortable in a professional business environment.
Bilingual Spanish a plus.
Valid Driver’s License in good standing.

The expected salary range for this position is $85,736.31 - $105,000. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law.
Medical, Dental and Vision Insurance.
Flexible Spending Accounts.
Paid Parental Leave.
Life, AD&D and Disability Insurance.
401(k), Employee Share Purchase Plan (ESPP).
Education and Training Reimbursement.
Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave.
10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays.
Employee Assistance Program (EAP).

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