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SalaryIndependent Contractor - Medical Field Case Manager/Nurse/Rehabilitation - Workers Compensation - Located in Houston, TX
- Bilingual in Spanish/English required
- Must have certification as Case Manager, i.e., CCM, CRN, CDMS, CRC, COHN
- RN preferred
- 1099 Contractor position
The successful candidate will be familiar with Texas Workers' Compensation as well as ODG (Official Disability Guidelines) and will collaborate with physicians and the multidisciplinary team including adjusters, medical care providers, and employers to facilitate the plan of care and assist in identification and concurrent resolution of variances.
The FCM acts as a liaison for the injured employee and communicates with the client while maintaining neutral position between all interested parties. They provide assistance to claimants as needed with selection of treating physician from the Network provider list as well as assist claimants and physicians with specialist referrals and ensure utilization of providers within the Network. It is important to maintain communication with employer, claims adjuster as needed for coordination of RTW (Return to Work) efforts and initiate required forms and letters of communication as indicated throughout the case management process.
They utilize clinical/nursing skills to coordinate the individual's treatment program while maximizing cost containment and provide documentation in the IMO SmartCat Software, updating notes on the initial medical assessment/interview, medical status and RTW Status. Communication with claims examiners is critical; may be necessary to participate with file reviews to ensure that disputes or other non-medical issues are addressed accordingly.
FCM will attend appointments in the field with injured employee to facilitate needed care and treatment for RTW. No home visits are required.
