Medical case manager job description

This post includes 3 parts: duties list, job qualification and job description writing tips for Medical case manager in details. A complete job description concludes Medical case manager key duties/responsibilities, Medical case manager job qualifications (knowledge, education, skills, abilities, experience…KSA model) and other ones such as daily tasks, key activities, key/core competencies, job functions/purpose…

I. List of Medical case manager duties:

1. Reviews case records and reports, collects and analyzes data, evaluates client's medical and vocational status and defines needs and problems in order to provide proactive case management services.
2. Demonstrates ability to meet administrative requirements, including productivity, time management and QI standards, with a minimum of supervisory intervention.
3. Renders opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate rehabilitation goals and return to work.
4. Performs job site evaluations/summaries; prepares monthly written evaluative reports, denoting case activity, progress and recommendations in accordance with state regulations and standards. 
5. Facilitates timely return to work date by establishing a professional working relationship with the client, physician, and employer. Coordinate return to work with patient, employer and physicians.
6. May recommend and facilitate completion of peer reviews and IME's by obtaining and delivering medical records and diagnostic films as well as conferring with physicians both in person and on phone.
7. May review files for claims adjusters and supervisors.
8. Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for case management for the client.
9. May obtain referrals from branch claims offices.
10. Utilizing experience and medical resources interprets medical records and test results and provides assessment accordingly. Utilizes nursing process, case management standards of practice guidelines and Broadspire's Quality Improvement Guidelines in providing medical case management services.
11. May meet with employers to review active files.
12. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.
13. Travels to homes, health care providers, and various offices as required facilitating return to work and resolution of cases. (Approximately 70% of an OSCM's position is spent in travel). 
14. Reviews case with supervisor monthly to evaluate files and obtain directions.
15. May perform other related duties as assigned.

II. List of Medical case manager qualifications

1. CCM, COHN, CRRN or CDMS certification required
2. Associate’s degree or relevant course work/certification in Nursing
3. Three (3) years clinical experience preferably in Orthopedics, Neurology, Intensive Care, Occupational Medicine, or a related health care discipline.
4. Valid RN licensure in the state(s) the incumbent works in.
5. Must meet specific licensing requirements to provide medical case management services
6. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
7. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.
8. Excellent analytical and customer service skills to facilitate the resolution of case management problems.

III. Tips to write job description

1. Too-long job description:

Looking at a too-long job description can frighten the candidates off and drive the away. A job description, no matter how important the job is, should not be included in more than 3 pages. If one focuses on too many things at a time, he shall definitely lose focus on the main items and get overwhelmed by the remaining; So, keep it concisely.

2. Too-short job description:

While too-long can be a problem, too-short is more a problem. It will ruin the meaning of the job description. A too-short one means it lacks necessary details and therefore, the candidate will not be able to understand while reading it.

3. Listing unnecessary functions or job duties:

Just classifying these into the “others” category will save you a lot of effort and space. On the other hand, the job description will become more dilute and easy to be neglected.

4. Key functions

Not listing key functions as required for the job can be a fatal mistake to a job description.

5. Grammar and spelling

Poor grammar and having spelling errors can ruin the job description, too. Never think that as you are the employer, you may have the right to make grammar or spelling errors while requires other not to. A job description with such errors is easily to be mistaken as a fake or ghost ads; as a result, the candidate will turn away from it.

6. Not specific enough:

Be specific and concise; if you don’t address the specific, then what the job description is for. It is for the candidate to understand just exactly what he needs to do or needs to have. Lacking details can confuse the candidates very well.

7. Not having the job description reviewed by others:

This is also a common mistake. One may be subject to bias, but more than one, especially with the help of those external advisor, the job description can be more perfect.

8. Using buzzwords or abbreviations:

In fact, it is not necessary at all to use such in a job description.

9. Using slang or legal words:

Just use common wording to communicate with others and don’t do anything extraordinarily.

10. Not updating the job description:

The same job may require different duties and responsibilities in different times, so, you cannot use the same job description for 2 different times.