** This position requires 2 years of experience in Utilization Review, Quality or Care Management, Disability Plans, FMLA and ADAA
Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.
As Disability Plan Nurse, you will primarily review short-term disability request forms based on the recovery period, correspond with the requesting physician, identify complications associated with procedures and monitor employee outcomes. Typically, you may work with 20 to 30 claims every day, so attention to detail and multi-tasking skills are essential. Utilizing your understanding of reviewing Epic notes, discharge summaries and procedure notes gained from your nursing/clinical roots, you will ensure your interactions with all caregivers and customers are supportive and understanding. On this team, you will find a collaborative dynamic, with each member actively encouraging growth and excellence.
A caregiver in this position works remotely from 8:00AM – 5:00PM, with a hybrid schedule during training.
A caregiver who excels in this role will:
- Utilize clinical expertise to achieve quality outcomes in a cost effective manner for the disability plans.
- Review leave of absence documentation provided by physicians, nurses, social workers, dietitians and other members of the health care team to achieve appropriate utilization of benefit plans.
- Prepare background and medical data for use in committee review and related processes.
- Monitor and evaluate care delivery and employee responses to ensure critical and/or recovery is following normal and customary courses.
- Track and record employee's progress and identify variances.
- Modify benefit coverage periods in case of complications.
- Ensure documentation of the revised benefit coverage period is provided to employee and supervisor.
- Manage each employee's transition throughout the benefit period to ensure compliance with polices.
Minimum qualifications for the ideal future caregiver include:
- Graduate from an accredited school of Professional Nursing
- Current state licensure as a Registered Nurse (RN)
- Three years of clinical nursing experience
- Two years of experience in Utilization Review, Quality or Care Management, Disability Plans, FMLA and ADAA
Preferred qualifications for the ideal future caregiver include:
- Bachelor’s of Science in Nursing (BSN)
- Case Management or Care Utilization experience
Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/
Physical Requirements:
- Working in a stationary position for extended periods
- Traveling throughout the hospital system, other locations and international locations as needed
- Operating a computer, audio visual and other office equipment
- Ability to communicate and exchange accurate information, including delivering any applicable training in person and virtually
- In some locations, moving objects up to 25 pounds
Personal Protective Equipment:
- Follow standard precautions using personal protective equipment as required
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System’s Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.