Clinical Case Manager-RN

About the role

The Clinical Case Manager-RN will offer clinical expertise, act as a liaison in disability cases, and utilize MDGuidelines to support medically sound decisions. They will ensure effective administration of absence and disability claims while delivering compassionate care to client employees.

Responsibilities

• Serving as primary resource on team managing medical disability and accommodation cases.
• Delivering case presentations to a panel, utilizing compelling communication, critical thinking, negotiation, holistic case analysis, and proactive case management skills.
• Displaying a professional/corporate presence and presentation style with the ability to demonstrate excellent problem-solving skills when questioned on your case management plans.
• Consulting on medical, behavioral health, and accommodation claims as needed, if within the scope of licensure and clinical expertise.
• Supporting employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations.
• Acting as a liaison between all parties required in case management to facilitate continuous communication and consensus.
• Serving as a liaison to the client's EAP, coordinate care, and encourage referrals to top behavioral health providers.
• Providing documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavour.
• Managing caseload efficiently, organize priorities, provides timely interventions, and maintains sensitivity to confidential records. Driving return to work process from beginning of case to closure.
• Ensuring quality standards for case management are met; implement Alight's continuous quality improvement process whenever efficiencies or quality standards are not met.

Requirements

• Be a Registered Nurse, Nurse Practitioner, or comparable license with experience, with working knowledge of disability, client processes, and case management.
• Have minimum of 5 years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review.
• Have minimum of 2 years' experience as a Clinical Case Manager.
• Demonstrate dedication to providing high quality customer service, using diplomacy, patient advocacy, and professional competency.
• Foster interest in collaborating with compassionate clinicians and leaders who prioritize mutual care and the well-being of customers and employees.
• Have degree as RN and valid licensure.
• Application and Interview
• Alight requires all virtual interviews to be conducted on video. Please be aware that A

Benefits

Additional Information

Come make a difference and consider this unique opportunity to step into a rewarding career. Amazing Opportunity and Great Place to Work! Our story At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight." We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.

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