Return to Work Consultant
Location:
Posted:
November 10, 2016
Reference:
94631
Description: The return to work coordinator (RTWC) is responsible for providing early intervention in the medical and return to work (RTW) management processes for injured workers. The RTWC collaborates specifically with the front line manager as well as all pertinent parties involved in the process to assess, plan, implement, coordinate, monitor and evaluate options and services required to achieve quality, cost-effective outcomes related to achieving RTW milestones. The focus of the RTWC is to optimize opportunities for workers whose RTW progression is at risk for exceeding the waiting period or becoming prolonged with the goal of avoiding permanent disability.
  • Oversee Third Party Administrator (TPA) claims handling on claims involving return to work to ensure all efforts of return to work are being pursued, all cost containment measures are being initiated at the right time, action plans are appropriate and demonstrate a target for full return to work.
  • Conduct audit sessions to optimize return to work opportunities
  • Coordinate with other partners in the process to achieve return to work.
  • Direct interface with Operations, Human Resources, Internal Claims Team, Safety and Risk Control, Fleet, Legal, and other pertinent Aramark personnel on claims to assist in investigation, return to work opportunities, Interactive process and employee relation matters under ADA and FEHA.
  • Identify trends that impact the financial cost of the claims and bring it to the attention of the responsible parties.
  • Support National WC Claims Manager with department and corporate objectives as assigned.
Essential Functions:
  1. Provides return to work management in a workers' compensation environment
  2. Conducts and documents in Riskonnect an initial assessment with the injured worker, employer, and provider to collect information needed to collaboratively formulate a RTW case plan
  3. Develops appropriate RTW plans with a balance between quality of care and cost effectiveness
  4. Facilitates early intervention for return to work programs
  5. Provide medical and/or disability case management services including review and evaluation of WC claims
  6. Participates in ad hoc file reviews, roundtables on complex and catastrophic cases
  7. Documentation is clear, concise and reflects strong technical and clinical knowledge and effective communication skills
  8. Serve as an informational and medical resource for the Internal Claims Team staff
  9. Support other team members to enhance overall team performance.
  10. Special projects as dictated by the AVP Strategic Claims and/or National WC Manager.
Performance Expectations
  1. Demonstrates mastery of the nursing process (assess, plan, implement, coordinate, monitor and evaluate) in accordance with established national standards for case management / RTW activities.
  2. Assessment activities - collect in depth information, from the injured worker and all other relevant sources, needed to develop a comprehensive, collaborative RTW plan to address client needs
  3. Plans of care - establish specific objectives, RTW goals, timeframes for follow-up and expectations for response to field inquires on post loss process, resources to be utilized, collaborative approaches to be used and actions designed to meet the client's needs
    1. Plan of care is action oriented and time specific
    2. Incorporates barriers and guidelines into action plans
    3. Communicates effectively to all parties expectation for return to work
  4. Demonstrates the ability to coordinate care in an organized manner to secure, integrate and modify resources necessary to accomplish RTW goals
  5. Monitors the RTW plan and its progression to determine effectiveness of plan of care and progression of work status; estimated length of disability is defined and monitored
  6. Performs repeat evaluations of the effectiveness of the RTW plan to reach quality, cost effective outcomes and goals
    1. Modifies plan of care as indicated to achieve desired objectives and goals
    2. Evaluates the recovery needs of the injured worker by ongoing contacts with relevant sources: provider(s), employer, employee, claims personnel, case management, legal representatives
  7. RTW activities demonstrate the appropriate recommendation for use of field case management
  8. RTW activities demonstrate the appropriate use of managed care tools; utilizes Bunch physician consulting services for contact where appropriate
  9. Maintains a minimum closure ratio of 1:1
  10. Supports Internal Claims Team and broader GRM with medical questions within scope of expertise


Qualifications:
  1. The desired candidate will have a fluent understanding of the workers' compensation claims handling process.
  2. Bachelor's degree in a health related field and licensure as a health professional, OR certification as a case manager, OR LVN/LPN/RN licensure and three years clinical practice experience
  3. Ability to work independently and/or in a team setting
  4. Strong organization skills, time management
  5. Maintain current LVN/LPN/RN license, registrations and/or any professional designations that may be required with the jurisdiction
  6. Excellent keyboard and PC automation skills
Bilingual desired
A little about us:
At Aramark, we believe that each of our employees can play an important role in creating the great experiences that become lasting memories.

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