Location: Oak Ridge, TN
Job Title: Workers' Compensation Certified Nurse Case Manager
Career Level: Senior Specialist
Job Specialty: Workers' Compensation Case Management
What You'll Do
- Gather relevant information to assist in the investigation and evaluation of workers’ compensation claims through interviews, verbal or written communications, and medical records.
- Responsible for helping to ensure injured parties receive appropriate treatment directly related to their compensable injury.
- Attends medical appointments with injured employees.
- Communicates in person and by telephone with patients, medical providers, attorneys, and insurance carrier to provide ongoing case management.
- Works collaboratively with claim handlers/adjusters to ensure that all injured parties are on an appropriate treatment plan and to manage medical treatment to resolution. Participate in periodic claim reviews.
- Work with others in a tactful, congenial, and professional manner so as to gain their trust and cooperation and accomplish assigned tasks.
- Exchange ideas, information, and opinions with others to jointly arrive at decisions, conclusions, solutions, or otherwise solve disputes.
- Responsible for ongoing evaluation of treatment or return to work plan within established protocols.
- Interact with Occupational Health Services (OHS) and Environmental Safety &Health (ES&H) to obtain or clarify clinical information and participate in in-house case reviews.
- Maintain high standard of file documentation to ensure attention to detail and file accuracy, and provide timely reports, responses, and case updates.
- Provide comprehensive medical case management oversight of workers’ compensation claims.
- Advocate for appropriate services and treatment to attain best practices standards, maximum medical improvement and successful return-to-work.
- Communicate with employees, line management, Occupational Health Services (OHS), occupational safety and health administration (OSHA) recordkeeping, benefits, internal and external counsel, external providers, and others to ensure understanding of, and cooperation with, the recommended treatment plans and the goal of returning employees to meaningful work.
- Maintain required continuing education as outlined by CCM, TN Bureau of Workers’ Compensation, and CNS.
What You Can Expect
- Meaningful work and unique opportunities to support missions vital to national and global security
- Top-notch, dedicated colleagues
- Generous pay and benefits with a stable organization
- Career advancement and professional development programs
- Work-life balance fostered through flexible work options and wellness initiatives
Minimum Job Requirements
- Bachelor’s degree: Minimum 7 years of relevant experience as a workers’ compensation nurse case manager. Typical experience ranging from 10 to 15 years.
- RN with current state license required
- CCM certification required
Preferred Job Requirements
- Knowledge of and working familiarity with the Official Disability Guidelines (ODG)
- Knowledge of and working familiarity with the MD Guidelines
- Documentation and calculation of cost savings per case
- Strong problem solving and analytical skills
- Excellent interpersonal, oral, and written communication skills
- Good computer skills including use of Word and Excel
- Ability to interface with treating physicians, division managers, OHS staff, and employees
- Excellent organization skills
Why Y-12?
You get #morethanajob. We encourage employees to achieve a healthy personal balance among home, work and the community. One of the ways we embrace work-life balance is by offering flexible work arrangements that provide alternatives to the traditional workweek, while still meeting business needs. Top talent and personal commitment mean more to our success than any other factors, so we reward our people with the kinds of benefits that make a positive difference in the quality of their lives. Benefits such as: medical plan, prescription drug plan, vision plan, dental plan, employer matched 401(k) savings plan, disability coverage, education reimbursement and many more. Want to stay healthy and fit but hate the cost of a gym membership? Take advantage of one of our onsite workout facilities and eat healthy in our onsite cafeterias. Much more than a workplace, at Y-12, you can build a career that lasts a lifetime.
Notes
The minimum education and experience for the lowest career level in the job posting range are listed under Minimum Job Requirements. Successful candidates hired into a higher career level than the minimum in the range must meet the requirements listed in the job leveling charts for the career level into which they are being hired.
If a range of Career Levels is posted, i.e., Senior Associate to Senior Specialist, internal applicants already in one of the Career Levels would come across at their current Career Level. Internal applicants currently in a lower level Career Level would move to the lowest posted Career Level.
Requires a Q clearance; however all qualified candidates will be considered regardless of their current clearance status. The ability to obtain and maintain a Department of Energy Q clearance is required.
This position may require entry into the Material Access Areas (MAA) and participation in the Human Reliability Program (10 C.F.R. Part 712), which requires successful competition of a DOE counterintelligence evaluation and may include a counterintelligence-scope polygraph examination.
This position may be categorized as a “designated position” identified by 10 C.F.R. Part 709, requiring successful completion of a DOE counterintelligence evaluation that may include a counterintelligence-scope polygraph examination.
CNS is a drug-free workplace. Candidates accepting a job offer will be required to pass a pre-placement physical, drug screening and background investigation. As an employee, you may be required to receive and maintain a security clearance from the United States Department of Energy in order to meet eligibility requirements for access to sensitive information or matter. U.S. citizenship is a requirement for security clearance applicants. All employees are subject to being randomly selected for drug testing without advance notification.
CNS is an equal opportunity employer. All qualified applicants will receive consideration for employment based on merit and without regard to race, color, religion, sex, sexual orientation, national origin, protected veteran status or disability.
