Sandia National Laboratories Medical Case Manager (Experienced) in Albuquerque, New Mexico
This posting will be open for application submissions for a minimum of seven (7) calendar days, including the ‘posting date’. Sandia reserves the right to extend the posting date at any time.
Sandia demonstrates its commitment to public safety in the national interest by requiring that all new hires be fully vaccinated or have an approved medical or religious accommodation before commencing employment. The requirement also applies to those who are telecommuting and working virtually.
Any concerns about the ability to meet this requirement should be directed to HR Solutions at (505) 284-4700.
Organization 03700, Employee Health Services, is currently seeking a Medical Case Manager to join their team!
The selected candidate will provide medical case management services for employee injury and illness cases, including return-to-work, fit for duty evaluations, workers' compensation cases, long-term disability/extended absence, and other non-occupational and occupational injury and illness cases for assigned client base. The successful candidate will use professional judgment and discretion to implement the medical treatment plan, including but not limited to: referrals, counseling on benefits/additional resources, adherence to treatment recommendations by Sandia Medical Clinic, and monitoring of restrictions and accommodations.
On any given day, one may be called upon to:
Consistently exercise discretion and judgment to analyze, interpret, make deductions, and then decide what actions are vital based on the varying facts and circumstances of each individual case
Document all employee case management interactions in electronic health record and maintain all records in accordance to policy and regulations
Work in conjunction with internal medical care providers, as well any case-specific necessary key customers such as the medical director, corporate attorneys, external medical providers, third-party administrators, EEO, human resource business partners, and managers.
Coordinate and attend meetings as needed to ensure medical needs of the employee are being met
Provide patient consultations
Provide specialized health education within scope of practice
Review, process, and approve documentation in relation to sick leave
Ensure communication with and education of Sandia Medical Clinic staff to ensure efficient and medically-necessary care
Update job knowledge by participating in educational opportunities; reading professional publications, maintaining personal networks, and participating in professional organizations
Ensure communication with leave administrator (HR) for compliance with state and federal laws (FMLA, Worker’s Compensation, California-specific leaves (PDL, CFRA))
Provide a centralized, strategic focus to reduce lost time for work-related accidents and rates of indemnity days paid, as well as coordinate care for return to work efficiency
Comply with privacy rules, including HIPAA, in the course of case management for the individual employee
Maintain a high level of ethical conduct regarding confidentiality, dual-relationships, and professional stature
A Bachelor's in a Human Services or Healthcare field plus 5 years related experience in case management and/or occupational health services
The ability to obtain certification from Commission for Case Manager Certification (CCM) or Certified Disability Management Specialist (CDMS)
The ability to acquire and maintain a DOE L-level security clearance
Knowledge and proficiency in electronic medical record systems and the ability to document thorough medical case notes
The ability to handle confidential information appropriately
A demonstrated ability to influence outcomes with no direct authority
Knowledge of Sandia’s benefits policies, practices, and procedures
Knowledge of federal and state laws governing benefits, including the Health Insurance Portability and Accountability Act, the Employee Retirement Income Security Act, FMLA, and Workers’ Compensation, as required
Experience and proven skill in conducting research, investigating alternative solutions, and recommending solutions to problems affecting benefits administration
The ability to prepare and present oral and written reports
Active Registered Nurse
Employee Health Services offers occupational and non-occupational onsite services to employees in NM and CA, including chronic disease management, EAP, acute care, surveillance program management, workers' compensation, and return to work programs.
Sandia National Laboratories is the nation’s premier science and engineering lab for national security and technology innovation, with teams of specialists focused on cutting-edge work in a broad array of areas. Some of the main reasons we love our jobs:
Challenging work with amazing impact that contributes to security, peace, and freedom worldwide
Some of the best tools, equipment, and research facilities in the world
Career advancement and enrichment opportunities
Flexible work arrangements for many positions include 9/80 (work 80 hours every two weeks, with every other Friday off) and 4/10 (work 4 ten-hour days each week) compressed workweeks, part-time work, and telecommuting (a mix of onsite work and working from home)
Generous vacations, strong medical and other benefits, competitive 401k, learning opportunities, relocation assistance and amenities aimed at creating a solid work/life balance*
World-changing technologies. Life-changing careers. Learn more about Sandia at: http://www.sandia.gov*These benefits vary by job classification.
Sandia is required by DOE to conduct a pre-employment drug test and background review that includes checks of personal references, credit, law enforcement records, and employment/education verifications. Applicants for employment need to be able to obtain and maintain a DOE L-level security clearance, which requires U.S. citizenship. If you hold more than one citizenship (i.e., of the U.S. and another country), your ability to obtain a security clearance may be impacted.
Applicants offered employment with Sandia are subject to a federal background investigation to meet the requirements for access to classified information or matter if the duties of the position require a DOE security clearance. Substance abuse or illegal drug use, falsification of information, criminal activity, serious misconduct or other indicators of untrustworthiness can cause a clearance to be denied or terminated by the DOE, resulting in the inability to perform the duties assigned and subsequent termination of employment.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status and any other protected class under state or federal law.
Job ID: 679041