Company Details Berkley Medical Management Solutions (BMMS) provides a unique managed-care service for W.R. Berkley Corporation. Our focus is on facilitating injured workers' successful and speedy return to work, benefiting both individuals and Berkley's insurance units. Established in 2014, BMMS integrates clinical practices, return-to-work strategies, and advanced software into a seamless system for managing workers' compensation cases. Our flexible technology platform allows extensive customization and continuous innovation. We deploy integrated systems to offer recommendations and professional services for managing each case efficiently. Our combination of technology, data analytics, and professional services ensures reliable results, reducing time and costs associated with case management. Responsibilities As a Telephonic Nurse Case Manager, you will: Assess, plan, coordinate, monitor, evaluate, and implement options to facilitate timely medical care and return-to-work outcomes. Coordinate and implement medical case management to facilitate case closure. Communicate promptly and comprehensively with employers, adjusters, and injured workers. Assess appropriate utilization of medical treatments through contact with healthcare professionals to ensure cost-effective, quality care. Review and analyze medical records and data to ensure proper case management and recommend progress strategies. Manage assigned caseloads, varying by number, territory, or jurisdiction. Maintain nursing licensure across relevant jurisdictions as required. Coordinate services like home care, medical equipment, IMEs, hospital admissions/discharges, and vocational services, evaluating their cost-effectiveness and quality. Document all activities and case progress following best practices. Review job analyses and descriptions with providers to support disability case management and return-to-work efforts. Participate in special projects assigned by leadership. Attend on-site meetings and professional programs as needed. Foster a teamwork environment. Maintain and update evidence-based medical guidelines relevant to treatment and work status. Obtain and uphold necessary state certifications and licenses, including case management certification (CCM) within 2 years of hire. Qualifications Minimum 2 years' experience in workers' compensation insurance and medical case management (preferred). At least 4 years of clinical medical/surgical experience. Strong communication skills, professionalism, and adaptability. Knowledge of medical and vocational resources in the workers' compensation industry. Self-motivated with the ability to perform independently. Proficiency in computer and technology skills. Fluency in English; Spanish skills are a plus. Education Graduate of an accredited nursing school with a current RN license. CA RN License preferred. RN compact license, CCM certification, and Bachelor of Nursing preferred. Additional Company Details: We are an equal opportunity employer and do not accept unsolicited resumes from external agencies. We offer a competitive salary and benefits, including health, dental, vision, life, disability, wellness programs, paid time off, 401(k), and profit-sharing. Salary range: $80,000 - $88,000. Actual compensation depends on various factors. Additional Requirements: Domestic U.S. travel up to 10%. #J-18808-Ljbffr BERKLEY TECHNOLOGY SERVICES
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