Salary and benefits are competitive. Salary is commensurate with qualifications and experience.
As a UW employee, you have a unique opportunity to change lives on our campuses, in our state and around the world. UW employees offer their boundless energy, creative problem solving skills and dedication to build stronger minds and a healthier world.
UW faculty and staff also enjoy outstanding benefits, professional growth opportunities and unique resources in an environment noted for diversity, intellectual excitement, artistic pursuits and natural beauty. All of which has allowed the UW to be nationally recognized as a Great College to Work For for four consecutive years.
Risk Services, a department in Compliance and Risk Services, innovates, uses industry best practices and collaborates with key partners to mitigate and cost-effectively finance risk. It provides services to all University schools, colleges, and administrative units in the areas of liability and workers' compensation claims management, risk financing, risk consulting, and strategic loss control.
Claims occur most frequently in the areas of workers' compensation, automobile, employment practices, medical professional and general liability, with lower frequency in marine protection and indemnity and first party property claims.
We have an outstanding opportunity for an Occupational Nurse Case Manager to work under the direction of the Director of Claim Services to improve medical outcomes in workers' compensation claims and facilitate return-to-work and recovery for the University and its workers in accordance with program policy, procedures, and state regulations.
The Occupational Nurse Case Manager accomplishes his/her mission by early identification of opportunities for appropriate medical intervention in the University's workers' compensation claims, including collaboration with the attending providers, injured workers, the state Department of Labor and Industries (L&I) claim managers, and others to avoid or reduce time loss and ensure that benefits are paid in accordance with state fee schedules. The Occupational Nurse Case Manager serves as a reviewer of and subject matter expert on the appropriateness of the medical components of all workers' compensation claims. Finally, the Occupational Nurse Case Manager proactively works with University departments by presenting injury trends and techniques for injury prevention.
The Occupational Nurse Case Manager is a critical part of the risk management function at the University and its Medical Centers.
Duties and Responsibilities:
Claims Case Management: 75%
Maintains a caseload of workers' compensation claims. Works closely with injured workers, supervisors, managers, and medical providers to place injured workers in light duty roles within their medical restrictions while they recover from job-related injuries. Facilitates a professional, medically responsible and efficient claims process, working closely with all interested parties, in order to get the injured person back to work as soon as possible.
Reviews medical aspects of all workers' compensation claims and assists the University in return-to-work of injured workers and prevention of excessive injury costs by early identification of opportunities for appropriate medical intervention. Contacts physicians, vocational counselors, and other providers to determine restrictions, treatment plans, or other medical issues necessary to assist with an employee's return-to-work. Proactively seeks second medical opinions where appropriate and communicates changes in restrictions to appropriate University staff on a regular and continuous basis.
Works collaboratively with Senior Return-to-Work Specialist to:
o Achieve improved medical outcomes, decreased absences and increased productivity at the University of Washington o Manage the University of Washington's claims caseload o Ensure L&I decisions do not inappropriately impact the University's industrial insurance premiums o Manage, develop and assist in implementing job modifications funded by L&I o Serve as Claim Services liaison to L&I. Conduct regular claim reviews with L&I claim staff, consult with the L&I claims staff to evaluate workers' compensation claims and discuss medical issues and options and respond to L&I's information requests. o Review initial Reports of Accident and regularly review case files to ensure the early detection and prevention of fraud.
Ensures that the University meets necessary legal requirements to assert defensible protests, appeals, and litigation as appropriate.
Initiates and manages protests, appeals, and litigation involving L&I decisions on the University's claims. Ensures that controversial claims benefit decisions are brought to the Board of Industrial Insurance Appeals, as appropriate, and ensures that the University's positions are well supported.
Regularly communicates and coordinates with: L&I, medical professionals inside and outside of the University, the Attorney General's Office, Environmental Health & Safety (EH&S), University medical centers, clinics, schools, colleges and divisions, and the Board of Industrial Insurance Appeals.
Maintains accurate, detailed and confidential records of claims communication.
Maintains data consistent with data integrity standards in Claim Services.
Responds to information requests from University staff and other parties as necessary.
Outreach and Education: 15%
Serves as primary liaison to assigned University units and cultivates relationships with key staff. Improves outcomes by working with University staff to determine appropriate alternative and light duty tasks for injured workers, proactively prevent work place injury and successfully navigate the claim process from start to finish.
Makes presentations to audiences of various sizes on claim trends and injury prevention. Conducts injury prevention training in consultation with EH&S and Employee Health.
Prepares and disseminates trend information for key departments on a regular basis.
Provides training and knowledge transfer to others in Claim Services and to other University audiences as appropriate.
Identifies and recommends policy changes related to worker injury, return-to-work, and occupational medical issues related to claims and workers' compensation
Serve as Medical Subject Matter Expert: 5%
Provides medical knowledge consultation services to other University and Claim Services staff.
Special Projects: 5%
Serves as Claim Services' representative on the University-Wide Health and Safety Committee.
Serves on relevant University committees as assigned.
Works on special projects or teams at the request of the Director of Claim Services.
Bachelor's degree in Nursing
Minimum of seven years of experience in one or more of the following, preferably in Washington:
-Managing the return-to-work function of an employer -Nurse case management -Managing workers' compensation claims -Vocational rehabilitation consulting
Excellent written and oral communication skills, with ability to communicate effectively with diverse audiences
Ability to analyze, interpret, and apply complex rules and regulations toward effective problem-solving
Ability to develop and deliver presentations for broad audiences
Ability to effectively and efficiently use computer systems and databases
Demonstrated customer service skills
Strong planning and organization skills
Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.
Experience in Occupational Medicine
Familiarity with L&I's Claims and Account System
Washington Workers' Compensation Claims Certification
Experience with in-house workers' compensation claims programs
Conditions of Employment:
Appointment to this position is contingent upon obtaining satisfactory results from a criminal background check.
As a UW employee, you will enjoy generous benefits and work/life programs. For a complete description of our benefits for this position, please visit our website, click here.
The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These may include Work Authorization, Criminal Conviction History, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select Apply to this position. Once you begin an assessment, it must be completed at that time; if you do not complete the assessment, you will be prompted to do so the next time you access your My Jobs page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergra...duate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.