Clinical Case Manager

MMRO's Clinical Case Manager works remotely and facilitates all patient care telephonically.  There is no face to face patient care.  MMRO is an Independent Review Organization and manages Disability / Disability Retirement & Healthcare Claims and Appeals. In this position, the Clinical Case Manager is responsible for case management for patients that are on disability programs with a goal of returning to work at some point.  This service is called "Rehabilitation Services".

    • Identification of appropriate Rehabilitative Services case management track (Catastrophic or Active).  
    • Perform telephonic Clinical Assessment of disabling and impacting co-morbid condition(s), which includes, but is not limited to: Activities of Daily Living Assessment; Psycho-Social Assessment; history of recent hospitalizations, review of current clinical status (as of time of outreach), review of current treatment plan and medications, identification of current treating physicians, identification of special needs, and identification of case-specific periodic outreach interval. 
    • Development of customized, member-specific clinical Case Management Plan.  
    • Perform ongoing periodic telephonic clinical outreach at intervals determined upon completion of Clinical Assessment and Case Management Plan.  
    • Perform the periodic telephonic clinical outreaches at the schedule timeframe, consistent with the format and structure as required. 
    • Request and determine receipt of necessary information/documentation to help identify ongoing case management needs.  
    • Development of a comprehensive case management resource library from which to provide members information relevant to their disabling and impacting co-morbid condition(s).  
    • Determine MBR necessity via information gathered from the telephonic outreaches and documentation received for a return to the member’s own occupation. 
    • Determine appropriate physician specialty for MBR, when need is identified. 
    • Clinical Case Manager will be responsible for providing the appropriate vocational resources and tools to assist members in their efforts to seek employment in the labor market. 
    • Provide educational resources, including pamphlets, community resources, workshop information, and other relevant information deemed necessary to maximize employability.
    • Communicate with members, physicians, employers, and clients, as deemed appropriate.  

    Applicants must have a current RN license with no sanctions. Associates degree required, bachelors degree preferred. Relevant experience is required. CCM certification preferred, required within 6 months of hire.



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