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Managed Care Network, Inc.

Legal Nurse / WC Sr. Nurse Case Manager / WC Claims Nurse

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What they do

A Nurse Case Manager applies nursing expertise to coordinate a patient's medical care and provides advocacy to help them get the best and most affordable care. Develop care plans including discharge planning, coordinate delivery among providers, and teach patients and families how to follow the plan. They may also help patients navigate insurance and other healthcare bureaucracies and access related social services. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment.

$79,064 / year median in New York

+7% projected growth

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Job Description

LPN or RN Legal Nurse / WC Senior Nurse Case Manager / WC Claims Nurse in our Claims & Medical Special Services Department Company Overview Managed Care Network, Inc. is an established managed care company who strives to be the best employer in the Worker's Compensation and No-Fault marketplace by living our values and by providing a work environment that employees can be proud of. Through our company values, we promote employee growth so each person can Thrive and are appreciated for the expertise, hard work, and passion they bring to the company. We provide unique solutions quickly to solve problems and to make our customers' jobs easier.
Core Responsibilities:
Reviewing medical records Compiling chronologies and analyzing pertinent treatment and medical records Understanding New York State Permanent Impairment Guidelines Correctly applying regulations and guidelines to specific scenarios Drafting various reports, letters, and/or other communication Contacting medical offices, claimants, employers, and various other individuals Maintaining required processes to ensure quality standards are maintained Presenting findings collaborating with the Medical director, Legal, and other team members.
Preferred Experience:
Legal Nurse experience Nurse Case Manager with NYS Workers Comp claims knowledge Physician's office Hospital, Community Health experience Claims experience with an insurance company New York State Workers Compensation o New York State Workers Compensation Medical Treatment Guidelines o New York State Permanent Impairment Guidelines Nurse/Medical Case Management Utilization Review and/or Utilization Management.
Skills:
Attention to Detail Computer skills Analytical and communication skills The ability to adapt and quickly develop an understanding of new or changing rules, regulations, and/or laws An ability to prioritize different workloads Time management The ability to work independently, while meeting deadlines and providing status updates as indicated The ability to multi-task The ability to work collaboratively, as part of a team
Job Type :
Full-time Salary:
$80,000 - $95,000 Physical setting/
Work Location:
Hybrid/Remote in Grand Island, NY 14072.
Schedule:
8-hour shift Day shift o Post-training schedule can be flexible Monday to
Friday License/Certification:
LPN or RN ( Required ) CCM / Certified Case Manager (Preferred)
Pay:
$80,000.00 - $95,000.00 per year
Benefits:
401(k) 401(k) matching Dental insurance Free parking Health insurance Life insurance Paid sick time Paid time off Vision insurance
Work Location:
Hybrid remote in Grand Island, NY 14072