<p>Great opportunity for a Medical Case (RN) Manager - Workers' Compensation Claims!</p> <p>Living in or near Pittsburgh, PA or Mid Ohio? This is for direct hire employment. Travel to appointments up to 3 days/week. Most will be within 1-2 hour drive.</p> <p>RESPONSIBILITIES:</p> <ul> <li>As a Medical Case Manager, you will make a meaningful difference in the lives of injured workers and their families </li><li>Work from home, and attending appointments. Monday - Friday (8am - 5pm). Up to 3 appointments weekly, meeting injured works to coordinate care with provider. </li><li>Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others </li><li>Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans </li><li>Evaluates patient's treatment plan for appropriateness, medical necessity, and cost effectiveness </li><li>Provides assessment, planning, implementation and evaluation of patient's progress </li><li>Attends doctors, other providers, home and in some cases, attorney's visits </li><li>Attends hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy. Initial home visit for initial evaluation </li><li>Negotiation the delivery of durable medical equipment and nursing services </li></ul> <p>Compensation:</p> <ul> <li>Starting salary is based on experience -$80K - $90K </li><li>Mileage reimbursement. </li><li>Office equipment provided </li><li>Monthly bonus potential </li><li>Excellent employee benefits </li></ul> <p>QUALIFICATIONS:</p> <ul> <li>5 years Clinical experience - Trauma, Critical Care, Orthopedics, Surgical or HHC </li><li>1 - 3 years preferred in Medical case management, Utilization review, or Managed care </li><li>Hospital discharge planning or home evaluations </li><li>Proficient computer skills - MS Office (Word, Excel, Outlook, Teams) and use of multiple monitors </li><li>Registered Nursing Diploma or associate's degree in nursing with an active Indiana License </li><li>Case Manager Certificate preferred (CCM, CIRS, or equivalent); Must be willing to obtain within 36 months </li></ul> <p>OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/</p>