Workers' Compensation/IDM Case Manager Job in Denver, Colorado US
Workers' Compensation/IDM Case Manager
Manage Workers Compensation (WC) claims Integrated Disability Management (IDM) transitional work for all KFHP CPMG employees. Maintains supports a culture of compliance, ethics integrity. Maintains knowledge of policies procedures performs in accordance w/ the Principles of Responsibilities applicable regulatory requirements, external laws accreditation standards. Appropriately reports observed fraud or abuse applicable regulatory requirements accreditation standards, to include OSHA recordkeeping application for the WC Self-Insured permit. Appropriately reports observed fraud or abuse. Builds collaborative relationship w/ employees/patients, KOJ, TPA, Employee Health, ERLR, managers/stewards, etc. Essential Functions: - Workers Compensation Case Management-Write policy procedure for the WC dept in keeping w/ CO WC law KPCO policies - Evaluates provides recommendations related to initial WC claim filings WC cases; accepted, pending or denied. Liaison w/ the employee/patient allied professionals such as their supervisor/manager, the TPA, KOJ clinics Ergonomist. Monitor medical claim status - Setup monitor modified work - Provide required WC documents to the TPA as requested/required - Provides relevant information to ER/LR Labor for the purpose of managing labor grievances, investigations, disputes, employee issues concerns related to IDM WC - Generate monthly quarterly reports, calculating injury rate, type trending - Conducts quarterly case reviews w/ our TPA, then implements plan of action - Leads investigations into incident/accident analysis or root causes to abate injuries - Integrated Disability Case Management- Promotes expedites an employee's return to modified/transitional work following temporary medical restrictions from an occupational or non-occupational injury, illness or condition - Coordinates consults w/ allied professionals to overcome any obstacles to the employees expedite prompt appropriate return to work - Ensures that the Region's transitional work disability management policies, procedures practices meet applicable legal labor requirements. This includes applicable collective bargaining agreements provisions, state laws federal regulations including ADA, HIPPA, FMLA Workers Compensation - Provides training about the Region's return to work policies, procedures compliance - Provides Leadership National IDM w/ routine reports of IDM production hours, demographics other metrics - Collaborates w/ allied professionals for an employee's permanent accommodation as indicated feasible - In addition to defined technical requirements, accountable for consistently demonstrating service behaviors principles defined by the KP Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives - Also accountable for consistently demonstrating the knowledge, skills, abilities behaviors necessary to provide superior culturally sensitive service to each other, to our members to purchasers, contracted providers vendors Qualifications: Basic Qualifications: - A minimum of 3 years of experience in case management required w/ an emphasis in occupational medicine or vocational health - A minimum of 1 year of experience in return to work disability management required - Bachelor's degree or equivalent experience in Human Resources, Business Administration, Psychology, Nursing, occupational health or related field Working knowledge of ADA, FMLA, HIPPA, DOL Workers Compensation regulations - Working knowledge of Ergonomics preferred - Effective negotiation, problem solving, communication, presentation, consulting leadership skills - Working knowledge of MS Office products to include Excel (formulas, pivot tables, graphs)