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State of Wyoming Workers' Comp Nurse Case Manager 2024-01275 in United States

Workers' Comp Nurse Case Manager 2024-01275

Print (https://www.governmentjobs.com/careers/wyoming/jobs/newprint/4555542)

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Workers' Comp Nurse Case Manager 2024-01275

Salary

$6,761.03 - $7,512.25 Monthly

Location

Cheyenne, WY

Job Type

Permanent Full-time

Job Number

2024-01275

Department

Department of Workforce Services

Division

Worker's Comp - Cheyenne

Opening Date

06/25/2024

Closing Date

Continuous

FLSA

Determined by Position

Job Classification

SOMC10

  • Description

  • Benefits

  • Questions

Description and Functions

Open Until Filled

GENERAL DESCRIPTION:

The Department of Workforce Services is seeking a Nurse Case Manager to coordinate, evaluate, and monitor medical care services being provided to injured workers receiving benefits under the Workers' Compensation system; provide assistance to health care providers, employers, and division professionals in coordinating care and treatment plans to return injured workers to a pre-injury status and return to work.

Human Resource Contact: kelly.gayer@wyo.gov

ESSENTIAL FUNCTIONS:The listed functions are illustrative only and are not intended to describe every function which may be performed at the job level.

  • Evaluate claimant needs and medical records to direct medical case management activities.

  • Provide assistance to healthcare providers, employers, and division professionals in coordinating care and treatment plans.

  • Ensure that appropriate medical care is delivered to injured workers in a manner that is consistent with the statutes, rules, and regulations of the division.

  • Perform a medical review screening on pre-authorization requests for proposed surgical procedures.

  • Obtain all medical documentation to accompany the pre-authorization requests.

  • Refer cases for peer review as indicated from treatment guidelines and medical reviews.

  • Document all interactions, reviews, approvals, and denials in the claims management system.

  • Review CPT and ICD-10 codes, and surgical descriptions for accuracy on pre-authorization requests.

  • Review medical documentation utilizing the Division's treatment guidelines for surgical procedures.

  • Maintain tracking of all pre-authorization referrals, surgical procedures, clinical bills, and prescription requests

  • Review pre-authorization provider requests for compliance with treatment guidelines.

  • Act as a medical resource for claims analysts; write medical questions for multi-types of evaluations.

  • Review medical bills, prescription requests, UDS, chiro/PT treatments, and DME for relatedness.

Qualifications

KNOWLEDGE:

  • Knowledge of community resources.

  • Skills in counseling and consultation.

  • Ability to apply principles of nursing, particularly medical terminology, and physical and psychosocial principles.

  • Ability to interpret diagnostic testing.

  • Ability to critically analyze data.

MINIMUM QUALIFICATIONS:

Education:

Bachelor's Degree (typically in Nursing)

Experience:

1-2 years of progressive work experience (typically in Nursing)

Certificates, Licenses, Registrations:

Must be licensed or eligible for licensure as a Registered Nurse (RN) in the State of Wyoming

OR

Education & Experience Substitution:

4-6 years of progressive work experience (typically in Nursing)

Certificates, Licenses, Registrations:

Must be licensed or eligible for licensure as a Registered Nurse (RN) in the State of Wyoming

Necessary Special Requirements

PHYSICAL WORKING CONDITIONS:

  • Minimal travel may be required.

NOTES:

  • FLSA: Exempt

  • The Wyoming Department of Workforce Services (DWS) uses E-Verify, an Internet-based system, to confirm the eligibility of all newly hired employees to work in the United States. Learn more about https://www.e-verify.gov/ , including your rights and responsibilities.

  • For the Veteran's preference consideration, supporting documentation must accompany your application.

  • Former State of Wyoming employees, who are rehired within 31 days from their previous employment, will be required to reimburse the State of Wyoming for all Vacation and Sick leave compensation received upon separation.

  • Offers of employment will be contingent upon the successful completion of a background check.

Supplemental Information

Clickhere (https://ai.wyo.gov/divisions/human-resources/consultative-services/compensation/pay-tables-salary-averages) to view the State of Wyoming Classification and Pay Structure.

URL:http://agency.governmentjobs.com/wyoming/default.cfm

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

Class Specifications are subject to change; please refer to the A & I HRD Website to ensure that you have the most recent version.

Working for the State of Wyoming provides employees with a range of valuable benefits and offers a fulfilling career path. Employees enjoy comprehensive healthcare coverage, including medical, dental, and vision plans, ensuring their well-being and that of their families. Additionally, the state offers multiple retirement plans, which provide financial security and stability for employees once their career in public services comes to an end. the state recognizes the importance of personal time and offers generous paid time off and flexible arrangements, allowing employees to recharge, take care of personal matters, and maintain a healthy work-life integration.

There are many benefits to living and working in Wyoming. Beautiful country with wide-open spaces, clean air, great recreational activities, and no State income tax to mention a few!

Click here (https://ai.wyo.gov/for-job-seekers) to learn more!

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