Overview:
POSITION SUMMARY:
Functions as the primary Workers’ Compensation Case Manager within an onsite employer‑based clinic, coordinating the full continuum of care for employees with work‑related injuries and illnesses. Primary responsibilities include injury case management, claims administration, care coordination, employer communication, regulatory compliance, and return‑to‑work planning within a high‑volume manufacturing environment. Serves as the clinical liaison among employees, providers, employer leadership, safety teams, insurance carriers, and third‑party administrators, while also providing limited direct clinical care, triage, and first aid as needed. Acts as the electronic medical record (EMR) superuser and supports clinic operations through clinical expertise, staff education, and process coordination.
Responsibilities:
KEY RESPONSIBILITIES / ESSENTIAL FUNCTIONS:
Workers’ Compensation Case Management (Primary Function):
- Serves as the primary case manager for work‑related injury and illness cases from initial report through resolution.
- Coordinates all aspects of workers’ compensation claims, including injury documentation, claim entry into insurance or third‑party databases, and ongoing claim management.
- Communicates routinely with insurance carriers, adjusters, nurse case managers, and employer representatives regarding claim status and care progression.
- Coordinates specialist referrals, diagnostic testing, imaging, and follow‑up care in accordance with workers’ compensation guidelines and employer processes.
- Facilitates and tracks physician panel requests and changes in accordance with regulatory or employer requirements.
- Assists with completion and coordination of FMLA and related medical leave documentation when applicable.
- Supports return‑to‑work, transitional duty, and fitness‑for‑duty processes through collaboration with providers, safety teams, and employer leadership.
- Coordinates emergency department visits when required and ensures appropriate follow‑up and documentation.
Care Coordination & Employer Collaboration:
- Serves as the primary clinical liaison with employer leadership, safety personnel, human resources, and payroll regarding work‑related cases.
- Communicates work restrictions, medical updates, and care plans within established privacy and regulatory guidelines.
- Coordinates with payroll or designated employer contacts regarding injury‑related absences, restricted duty, and work status updates.
- Identifies trends in workplace injuries and escalates concerns or recommendations to leadership as appropriate.
Clinical Care, Triage & First Aid:
- Provides onsite triage and initial assessment of employees presenting to the clinic.
- Delivers first aid, minor injury treatment, and limited clinical care as needed based on clinic operations.
- Administers vaccinations, medications, and treatments in accordance with provider orders and standing protocols.
- Assists with emergency response and escalation of care when indicated.
Surveillance, Screening & Occupational Health Services:
- Performs and coordinates occupational health surveillance and testing activities, which may include drug and alcohol testing, pulmonary function testing, audiometry, vision screening, EKGs, laboratory specimen collection, and immunizations.
- Ensures testing is completed accurately, timely, and in compliance with regulatory and employer requirements.
Documentation, EMR & Data Management:
- Acts as the clinic EMR superuser, providing advanced system support, troubleshooting, and workflow optimization.
- Enters and maintains complete, accurate clinical and case management documentation within the electronic medical record.
- Orders medications, diagnostic tests, and referrals in the EMR as authorized or directed.
- Ensures records are organized, confidential, and compliant with HIPAA, OSHA, and organizational standards.
Education, Training & Support:
- Provides clinical education and guidance to medical assistants and other clinic staff related to occupational health processes, documentation, and workflows.
- Educates employees regarding injury care, treatment plans, return‑to‑work expectations, and self‑management.
- Supports provider needs by anticipating documentation, test results, and case updates required for clinical decision‑making.
Clinic Operations & Professional Responsibilities:
- Maintains a safe, clean, and organized clinic environment.
- Manages medication inventory, supplies, and equipment readiness.
- Participates in on‑call rotation when required based on clinic needs.
- Attends required meetings, training, competency validation, and continuing education.
- Performs additional duties as assigned to support clinic operations and employer health objectives.
DCH STANDARDS:
- Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
- Performs compliance requirements as outlined in the Employee Handbook.
- Must adhere to the DCH Mission, Vision, and Values including creating positive relationships with patients/families, coworkers, colleagues and with self.
- Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
- Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
- Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
- Requires use of electronic mail, time and attendance software, learning management software and intranet.
- Must adhere to all DCH Health System policies and procedures.
- All other duties as assigned.
Qualifications:
MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE REQUIRED:
Required Education, Experience & Skills:
- Current Alabama RN Licensure.
- RN with 2 years’ experience.
Preferred Education & Experience:
- BSN and/or related bachelor’s degree in a healthcare field.
- Relevant experience in case management, leave management and/or worker’s compensation in an industrial setting.
- Must be able to read, write legibly, speak, and comprehend English.
WORKING CONDITIONS:
- Lifting up to 10 lbs. maximum and occasionally lifting and/or carrying such articles as files, patient charts, computer printouts, etc.
- Must have good manual dexterity. Hearing and vision must be normal or corrected to within normal range.
- Must be able to stoop, kneel, and/or crouch on occasion.
- Must be able to perform the duties with or without reasonable accommodation.
- Hearing and vision must be normal or corrected to within normal range.
- Physical presence onsite is essential.