Newbie in CMN

nurseprnRN, BSN, RN · Oct 21, 2013

Field case management in work comp needs a good deal of autonomy, assumes you have a broad clinical background (likely more than just one year-- I had almost 20 years in mostly critical care when I started, and most of my peers were similarly experienced in med/surg, orthor, neuro, and in one case, prison nursing/HIV/hepatitis), and most jobs require or strongly prefer certification in case management. This is totally not a job for a new grad, as the companies hire you for your clinical experience.

Your duties would include on-site assessment of the injured person and the worksite/job, perhaps suggesting an appropriate specialist, attending all physician visits, and proactively setting up services and re-evals. For example, if you ask the surgeon how soon PT will be starting after the knee surg, he'll say after the first postop visit in ten days, so you'll make the 10-day postop visit appt and the PT initial eval appt to follow the same day now. If you wait to make the PT appt after the postop check, you won't be able to get the patient in for another week or two -- avoidable delay. You'll monitor therapy, work with the employer to provide some sort of modified work during recovery, propose and get specific restricted-duty clearance from the physician, monitor return to work, and consult with the employer. You wold also educate the claims adjuster on all aspects of this injury and progress, write a note on every contact on the case (pt, doc, therapists, employer, etc,) obtain and review all medical records, write periodic reports, and keep track of all your time for all of this for billing purposes. You'll need to learn a lot about the work comp law in your state to know what you can and cannot do, deal with claimant attorneys, and set up and attend (if allowed) independent medical exams. That covers most of it. :)

Here's the link to the CCMC for more information in certification.

CCMC | The Commission for Case Manager Certification