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Since its founding in 1919, The Methodist Hospital, The Methodist Hospital System's anchor facility, has earned worldwide recognition. The Methodist Hospital is affiliated with the Weill Medical College of Cornell University and NewYork-Presbyterian Hospital, one of the nation's leading centers for medical education and research. Methodist is also affiliated with The Menninger Clinic, a national specialty psychiatric and behavioral hospital, ranked as one of 'America's Best Hospitals.' The Methodist Hospital directs millions of research dollars into patient care and offers the latest innovations in medical, surgical and diagnostic techniques. With 1250 licensed beds, 52 operating rooms and over 5000 employees, The Methodist Hospital offers complete care for patients from around the world.
The Disability Nurse (Health Advocate) is responsible for coordinating the management of claims under the occupational health and short term disability programs and minimizing liabilities resulting from those claims for The Methodist Hospital System. Demonstrates strong nursing competencies, case management expertise and knowledge of occupational health practices, OSHA and Workers' Compensation regulations.
DUTIES AND RESPONSIBILITIES
Coordinates occupational health and disability cases by working with employee, management and health care providers in order to ensure proper processing of claims, approve payment of benefits and a safe and timely return to work.
Supports return to work programs by identifying alternate temporary duties specified by the employee's treating physician. Identifies and discusses availability of work assignments and specific conditions of the employee's return to work conditions with management, human resources representatives and treating physician.
Focus on influencing medical care by intervening with the physician to achieve maximum medical improvement and to minimize permanent disability.
Assures compliance with policy and procedures as they apply to the disability programs and in the management of employee work related injuries and disabling health conditions.
Coordinates information dissemination and provide explanation of insurance programs, benefits and state and federal laws associated with disability to employee and management.
Pursue all claim resolution opportunities, which most effectively manage claim costs (i.e. investigation, medical management, return to work, review for questionable indicators). Arrange specialist appointments with Network Physicians when deemed necessary. Use Disability duration guidelines to minimize the duration of absence.
Review all claims for reasonable and necessary medical care/costs.
Maintains required professional competencies and licensure and certification requirements.
Ensures clinic and medical record confidentiality.
Demonstrates ICARE Values
Demonstrates Service Pride Standards
Follows all safety rules on the job
Performs other duties as assigned
Bachelors Degree in Nursing
Three to five years experience in occupational health and case management related to worker's compensation and/or short/long term disability claims.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
License to practice as a Registered Nurse in the State of Texas
Certification in Occupational Health Nursing and Case Management
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Demonstrates strong nursing competencies and case management expertise.
Demonstrate knowledge of Texas Workers' Compensation law, OSHA standards, Family Medical Leave Act and disability duration guidelines.
Strong customer service skills