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Vocational Rehab Specialist I - Disability Management
at Sedgwick CMS in Ohio
Vocational Rehabilitation Specialist I
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To communicate, coordinate and manage medical and vocational case management activities to ensure that all CHS and Bureau of Workers Compensation (BWC) performance standards are fulfilled efficiently and in a cost effective and quality manner.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Completes all vocational rehabilitation processing of referrals, reports, plans and closures per CHS/BWC policy.
Staffs current injured worker status with BWC, employer, vocational rehab case managers (QRPs) and service plan providers.
Communicates with injured workers who have been referred for vocational rehabilitation services regarding their eligibility, the referral process, the role of the vocational rehab case manager, verification of approved plan services and closure/appeal rights per BWC policy.
Receives and forwards all CHS responsibilities regarding medical management activities to the nurse case manager.
Provides assistance to other CHS departments with respect to the injured worker's vocational rehabilitation plan status.
Completes data entry requirements for documentation.
Conducts pre-plan staffing with QRP.
In conjunction with employers, identifies vocational rehabilitation services, treatment and claim benefit options that serve the objective of returning the injured worker to work or bring about claim resolution.
Understands the most current version of Chapter 4 of the MCO Policy Reference Guide and assures that those guidelines are applied in plan formulation.
Reviews plans to assure that services requested by QRP are ethical, efficient and return-to-work (RTW) focused.
Reviews plans to assure compliance with Chapter 4 guidelines for RTW hierarchy and plan elements.
Identifies gaps in treatment and facilitates plan accordingly.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
High School diploma or GED required.
Experience
One (1) year workers compensation, vocational rehabilitation, or medical experience required.
Skills & Knowledge
Knowledge of vocational rehabilitation, medical or workers compensation claims procedures and state legal and regulatory requirements
Good customer service skills
Good oral and written communication skills
PC literate, including Microsoft Office products
Excellent interpersonal skills
Good organizational and time management skills
Good problem solving skills
Good analytical skills
Ability to manage multiple and changing priorities
Ability to work in a team environment or independently with little supervision
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/16322565
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To communicate, coordinate and manage medical and vocational case management activities to ensure that all CHS and Bureau of Workers Compensation (BWC) performance standards are fulfilled efficiently and in a cost effective and quality manner.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Completes all vocational rehabilitation processing of referrals, reports, plans and closures per CHS/BWC policy.
Staffs current injured worker status with BWC, employer, vocational rehab case managers (QRPs) and service plan providers.
Communicates with injured workers who have been referred for vocational rehabilitation services regarding their eligibility, the referral process, the role of the vocational rehab case manager, verification of approved plan services and closure/appeal rights per BWC policy.
Receives and forwards all CHS responsibilities regarding medical management activities to the nurse case manager.
Provides assistance to other CHS departments with respect to the injured worker's vocational rehabilitation plan status.
Completes data entry requirements for documentation.
Conducts pre-plan staffing with QRP.
In conjunction with employers, identifies vocational rehabilitation services, treatment and claim benefit options that serve the objective of returning the injured worker to work or bring about claim resolution.
Understands the most current version of Chapter 4 of the MCO Policy Reference Guide and assures that those guidelines are applied in plan formulation.
Reviews plans to assure that services requested by QRP are ethical, efficient and return-to-work (RTW) focused.
Reviews plans to assure compliance with Chapter 4 guidelines for RTW hierarchy and plan elements.
Identifies gaps in treatment and facilitates plan accordingly.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
High School diploma or GED required.
Experience
One (1) year workers compensation, vocational rehabilitation, or medical experience required.
Skills & Knowledge
Knowledge of vocational rehabilitation, medical or workers compensation claims procedures and state legal and regulatory requirements
Good customer service skills
Good oral and written communication skills
PC literate, including Microsoft Office products
Excellent interpersonal skills
Good organizational and time management skills
Good problem solving skills
Good analytical skills
Ability to manage multiple and changing priorities
Ability to work in a team environment or independently with little supervision
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/16322565
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Published on Jun 18, 2010
Viewed: 408 times
Viewed: 408 times
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