Experience Inc. Jobs

Covenant HealthCare\ US:MI:SAGINAW\ DAY SHIFT\ FULL TIME BENEFITED\ Summary:\ This individual is responsible for and available to on an \'as needed\' basis for case management of a group of patients (employees) who have been injured while at work for Covenant HealthCare. This individual promotes collaboration with the patient care team to ensure a high quality of patient care, reduced time off from work, efficient utilization of resources, and appropriate reimbursement of care and services. The Employee Health/Workers Compensation Case Manager is responsible for following patients (employees) with complex injuries throughout the continuum of health care, including development of a return to work and/or employee retraining program. This individual ensures accurate documentation reflecting the acuity of work injury and treatment given for the injury and coordinates communications with physicians. The Employee Health/Workers Compensation Case Manager refers information to the third party intermediator for claims processing and bill payment. This individual also coordinates and manages the Workers Compensation lawsuits for the hospital; including managing claims against the facility, interfacing with defense legal counsel, and monitoring and analyzing employee incidents. The Employee Health/Workers Compensation Case Manager is also responsible for promoting the maximum level of health for employees through: screening health assessments, educational inservices, prevention programs, infection control, and wellness intervention.

The Employee Health/Workers Compensation Case Manager demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant and the commitment to Extraordinary Care for Every Generation.

Responsibilities:\ Provides consultation for employees experiencing work-related incident/illness.\ Coordination of case management and timely return to work of injured workers.\ Act as a liaison between department directors, managers, and supervisors in the return to work process.\ Establishes a good working relationship with ancillary departments (i.e. physical therapy, occupational therapy, and other health care providers providing services to injured employee.)\ Works effectively with Covenant Occupational Health Services, all other treating physicians, and third party insurance administrators of Covenant HealthCare Services.\ Collaborates with physicians and all other members of the multidisciplinary team to facilitate and ensure continuity, timeliness and appropriateness of care for designated case load; monitors the patient\'s progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; and ensures timely: 1) completion and reporting of diagnostic testing; 2) initiation and completion of treatment plan; 3) initiation and completion of discharge plan; 4) assignment of appropriate level of care; and 5) completion of all required documentation.\ Collaborates in the development, revision and evaluation of a multidisciplinary plan of care by continuously assessing patient and family needs from pre-hospitalization through post hospital services, when required.\ Initiates and manages transitions when the patient experiences the need for new and different services. Collaborates with and uses support of the Third Party Administrator (TPA) regarding cases with complex social service needs.\ Contact patients to provide him/her with education, identify needs, and set patient\'s expectations regarding course of recovery.\ Reviews cases for quality or risk management issues and intervenes when indicated. Documents issues and interventions in patient\'s file.\ Performs concurrent variance monitoring and works collaboratively to eff