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Years of Experience
Date Last Verified
ProfileNurse Consultant Manager Duties: Provides leadership and strategic direction for a national team of Nurse Consultants for all lines of business in Claims. Supervises assigned personnel. (See attached description of Supervisory Responsibilities) Actively collaborates with field claims leadership to insure consistent and effective standards, quality and operating protocols are in place for Nurse Consultants. Plans and directs the hiring of personnel to meet needs of claims client. Attends and participates in claims leadership meetings and conferences. Oversees the development and delivery of appropriate medical training and education of the claims professionals. May attend depositions and mediation proceedings as called upon to support claims professionals. Provides expert witness testimony in court and other administrative hearing processes and acts as consultant to defense counsel. Works with leadership team in the selection of medical vendors. Oversees the preparation and control of the budget and strategic plan for the Nurse Consultant team. Researches and monitors trends and developments in the area of medical treatment options and technologies. May be assigned supervision of Claims Representatives in Medicare Set-Aside unit. When supporting Workers’ Compensation, includes development of protocols and supervision of medical vendors. May perform other duties as assigned.
Qualification and Experience
Requirements: Nursing degree and a current Registered Nurse license. 8 years nurse consultant experience in medical review or insurance and 5 years management experience. Legal experience. Strong communication, writing, interpersonal and teaching skills. Must be currently certified as a Legal Nurse Consultant or a Nurse Case Manager by a nationally established and accredited testing organization or hold a Juris Doctorate degree. Highly desired that within 2 years of hire to complete Managers Leadership Development (MLD) and/or Advanced Leadership Development (ALD) if offered within a reasonable framework within that period.