Nurse Consultant - San Jose, CA

Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our clients and claimants, offering you the opportunity to join a team where your skills and dedication can truly make a difference. GUIDE. GUARD. GO BEYOND.

We believe that every candidate brings something special to the table, including you! So, even if you feel that you re close but not an exact match, we encourage you to apply.

Provides medical management to workers compensation injured employees, performing case management through telephonic and in-person contact with injured workers and medical providers. Coordinates with employers and claims professionals to manage medical care in order to return injured employee to work. This position will cover the San Jose territory with a travel radius of up to 2 hours.

Key Responsibilities:

• Coordinating medical evaluation and treatment
• Meeting with physician and injured worker to collaborate on treatment plan and to discuss goals for return to work
• Keeping employer and referral source updated regarding medical treatment and work status
• Coordinating ancillary services, e.g. home health, durable medical equipment, and physical therapy. Communicates with employers to determine job requirements and to explore modified or alternate employment.
• Discusses and evaluates results of treatment plan with physician and injured worker using Evidence Based Guidelines to ensure effective outcome.
• Documents case management observations, assessment, and plan.
• Generates reports for referral source to communicate case status and recommendations.
• Generates ongoing correspondence to referral source, employer, medical providers, injured worker, and other participants involved in the injured worker's treatment plan.
• May participate in telephonic case conferences.
• Maintains a minimum caseload of 35 files, and 145 monthly billable hours, with minimum 95% quality compliance.

Required

• Nursing or medical degree from an accredited institution with an active Registered Nursing license or medical license within the state of practice or states in which case management is performed.
• 2-4 years of work experience.
• Responsible for completing required and applicable training, in order to maintain proficiency and licensing requirements.
• Able to travel to appointments within approximately a 2 hour radius.
• Intermediate to advanced computer skills; Microsoft Office, Outlook, etc.

Desired:

• Bachelor's degree preferred.
• Worker's Compensation experience is preferred.
• Certification in related field preferred.
• 1-3 years of clinical experience preferred.

Work Traits:

• Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
• Advanced written and oral communication skills, along with organizational and leadership skills.
• Self-directed and proactively manage assigned case files.
• Demonstrates strong time management skills.

#LI-HL1

Click Here to review our U.S. Eligibility Requirements

We offer competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function), training programs, matching gift program, and more.