Registered Nurse (RN) - Case Manager, Acute Care Case Management
Lowe's Companies, Inc
Charlotte, NC

Lowes Care Nurse - Case Manager (Medicare Set-Aside)

Your Impact The Care Manager is a telephonic medical case management position with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment. Assessment and intervention, including psychosocial factors, for catastrophic and complex cases on workers' compensation injuries. Responsible for ensuring that employees receive appropriate treatment and/or assist claim examiners in managing medical treatment to an appropriate resolution. Apply medical treatment guidelines for future Medicare-covered expenses. The candidate will work directly for a Fortune 100 company with a high volume of claims per year for its US operations. The Care Manager will be responsible for medically managing a minimum caseload of 65 including review of claims identified for Medicare Set-Aside. What you will do * Manage an assigned caseload of medical workers' compensation case * Empower the employee with the tools to make informed decisions on their treatment options and set recovery expectations * This position will be responsible for evaluating factors requiring judgment and problem-solving; promote return to work * Work productively and in cooperation with internal and external personnel on a consistent basis * Educate claims examiners and human resource staff on medical issues * Team work for claims resolution * Ability to apply for professional licenses in assigned states as required * Pursues self-development and effective relationships with others by organizing resources and information; seeking performance feedback; adapting to and learning from change, difficulties, and feedback * Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; displays high of effort and commitment towards performing work and demonstrates responsible behavior * Ability to utilize clinical and nursing knowledge to determine future medical needs with associated costs * Utilize clinical and nursing skills to develop Medical Cost Projections and Medicare Set-Asides for workers' compensation and liability settlements based on published standards of practice. * Ability to interact with a MSA vendor on recommendations for reduction of medical costs * Identify and outline Medicare and Non-Medicare covered treatment. * Individual Contributor Required Qualifications: * Bachelor's Degree in Nursing or Associate's Degree with 5 years of experience in a clinical position. * 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation * Experience in a clinical position * 1-2 Years of Clinical experience * 3-5 Years of Experience required with Nurse Case Management Software, along with Microsoft Office * Unrestricted RN license in home State * CCM - Certified Case Manager * CRRN - Certified Rehabilitation Registered Nurse * CDMS - Certified Disability Management Specialist * COHN - Certified Occupational Health Nurse or certification eligible * CCM, CRRN, CDMS COHN or certification eligible to be completed within 2 years of hire Preferred Qualifications: * Demonstrated experience in crisis management, coaching, educating and negotiating About Lowe's Lowe's Companies, Inc. (NYSE: LOW) is a FORTUNE 50 home improvement company serving approximately 16 million customer transactions a week in the United States. With total fiscal year 2023 sales of more than $86 billion, Lowe's operates over 1,700 home improvement stores and employs approximately 300,000 associates. Based in Mooresville, N.C., Lowe's supports the communities it serves through programs focused on creating safe, affordable housing and helping to develop the next generation of skilled trade experts. For more information, visit Lowes.com. Pay Range: $58,100.00 - $96,900.00 annually Starting rate of pay may vary based on factors including, but not limited to, position offered, location, education, training, and/or experience. For information regarding our benefit programs and eligibility, please visit our benefits page. Lowe's hourly remote associates cannot reside in Alaska, California or Hawaii. Lowe's salaried remote associates cannot reside in Alaska or Hawaii. Lowe's is an equal opportunity employer and administers all personnel practices without regard to race, color, religious creed, sex, gender, age, ancestry, national origin, mental or physical disability or medical condition, sexual orientation, gender identity or expression, marital status, military or veteran status, genetic information, or any other category protected under federal, state, or local law. Qualified applicants with arrest or conviction records will be considered for Employment in accordance with applicable laws, including the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, and the California Fair Chance Act. Lowe's believes that conviction records may have a direct, adverse, and negative relationship to the following job duties: accessing company property, assets, information and products; partnering, supervising, and regularly working with other Lowe's employees; and adhering to and monitoring compliance and safety guidelines.