Employee Clinical Case Manager

 

JOB SUMMARY:

Provides Case Management activities relate to FHT employees enrolled in the FHT health plan. Responsible for managing employee engagement  with  individual health care and wellness goals in partnership with the Wellness department. Performs Employee Health Risk Assessments, disease management,  and manages the physician relationship with the employee in order to engage the employee is individual participation of chronic disease and wellness. Optimizes utilization by employees of available Health Care resources and Wellness programs.  Also includes making case management decisions for employees under care in our domestic facilities as well as those outside our facilities.  Will also manage all Leave of Absence programs including FMLA, Medical Leave, and Return to work, will work with the Employee Health Manager  for all leaves that involve Workers Compensation and Transitional Duty.

 

Excellent verbal and written communication skills.

Excellent computer skills and ability to interpret data and make evaluation and recommendation based on reported data. Familiar with Millennium data and Medicare protocols for treatment based on diagnosis.

Ability to work independently and provide Project Management across multiple stakeholders.

Able to manage Leave of Absence programs and demonstrate improved processes and savings to programs.

Knowledge of Case Management essential activities, and ability to apply these case management  functions to employee health management

Knowledge of health care programs including established treatment protocols and Medicare reimbursement requirements

Ability to understand and perform Employee Health Risk Assessments, and make recommendations based on these assessments.

Knowledge and understanding of disease management and physician /patient relationship management

Ability to facilitate employee involvement with their own individual health care and wellness goals, and to work with diverse health care entities, including Health Care Programs,  EAP, and Employee Health, Wellness, and Benefits departments.