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Case Manager

Occupational Health Nurse | Washington, DC | Contract

Job Description
Case Manager
Work Location: Washington, DC

Job Summary/Description
The Case Manager will conduct medical review of examination reports, test reports, and reports from personal physicians to determine if an incumbent or applicant meets medical qualification standards. Making and justifying medical determinations. Triaging medical records; Review of large military medical records; Writing detailed requests for documentation; Placing incumbent employees on restricted/limited duty based on the review of records; To assist with screening of potential applicants.

Job Duties/Responsibilities/Functions (including but not limited to)
• Maintains each case in the tracking system’s case management and enters data, such as; management notes, appointments, restrictions, accommodations, disability, etc.
• Provides periodic reports regarding status of cases.
• Monitors employee’s medical progress and duty status from the time of injury to return to full duty by conducting pre and post interviews with the injured employee and counsels the injured employee regarding their responsibilities.
• Obtains medical authorization release form from the employee
• Provides CA—l7's to employee prior to each appointment with the primary treating physician and requests periodic medical reports at reasonable intervals from the employee which addresses his/hers ability to return to Work.
• Ensure medicals and CA-l7’s are received timely and are complete. If medical documentation is not complete, returns documents to ‘employee with physician and employee instructional letters and requests employee contact physician for the required information.
• Contacts the physician in writing to obtain medical reports, obtain treatment plans, return to Work dates, descriptions of work limitations, and informs the physician of light/limited duty positions available and the speci?c requirements of the position for possible assignment.
• Upon return to work in a light/limited duty capacity, works with the employee and supervisor to ensure the duties to be performed are within the employee’s medical- restrictions and that both the employee and supervisor understands the limitations.
• Works with supervisor and BEP Workers’ Compensation Specialist to provide clari?cation of medical restrictions/limitations and/or provide advice regarding medications.
• Contacts-OWCP claims examiners to obtain updated medical reports and assesses potential return to date of injury position or light/limited duty.
• Facilitates approvals for surgery or other medical procedures/services.
• Monitors treatment provided and noti?es OWCP if it appears the physician’s care is inadequate, unreasonable or too lengthy and advises when a second opinion is needed.
• Assists in expediting medical and vocation rehabilitation by maintaining periodic contact with OWCP ?eld nurses and rehabilitation counselors regarding treatment progress diagnosis, expected recovery.
• Gathers information and documentation to make recommendations to OWCP to close Workers Comp. cases.
• Compiles documentation for pf all current applicable medical documentation for complex or unreasonable cases. This documentation may include medical records documenting periods of lengthy physician care, medical documentation of restrictions (or lack thereof) or inability to return to Work. This documentation will be provided to the Medical Review Officer (MRO) for a medical advisory opinion regarding the need for additional evaluation, such as, a Functional Capacity Evaluation, or a determination of adequacy of documentation to support Work status/capability testing, Fitness for Duty test.
• The MRO may also address appropriateness of the treating physician care, diagnosis or treatment, and the reasonableness of accommodation, restricted duty, no work etc.
• Review and identify cases on the charge back tiles provided by OWCP that need action by the Workers Comp. staff.
• Participate in routine staff meetings and monthly management meetings in conjunction with other Workers’ Compensation committee members to provide an update of cases in progress.
• Performs other related duties as required.

Minimum Qualifications
• Current RN State Licensure in residing state
• Knowledge of OSHA hearing requirements -Knowledge of interpretation of medical test findings (including spirometry, EKG.)
• Have a strong occupational health background PLUS a medical review background.
o Examples of a medical review background that can be confirmed on a resume include the following: Case management that includes review of medical records; Worker’s compensation case management; Disability case management; Review of fitness for duty records to include making recommendations for medical qualifications; Medical records screening.

About InGenesis
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.

EEOC Statement
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.