RN Patient Advocate

 

VML Insurance Programs (VMLIP) is the first and largest group self insurance pool in the Commonwealth of Virginia. For more than 30 years VMLIP has provided auto, property, liability, and workers’ compensation coverage to more than 470 local political subdivisions across Virginia.

 

VMLIP’s coverage and service programs are designed to meet the needs of all Virginia local governments – from the smallest to the largest. VMLIP provides comprehensive risk management program support, human resources, law enforcement and communications expertise and consulting, and more to members who contribute more than $54 million in annual contributions to the pool. We are “Virginia’s local government specialists.”


Headquartered in Glen Allen, VA, VMLIP has 55 employees. Our staff enjoys a great work environment along with a comprehensive benefits package which includes employee medical and a company funded retirement plan. We value continuing education and provide a tuition program and other learning opportunities. Please visit our website, www.vmlins.org for additional company details, including a summary of our employee benefit programs.


Currently, we have an employment opportunity for an RN Patient Advocate to provide comprehensive injury and treatment assessment for our member’s injured workers. Our patient advocates also support our claims representatives in catastrophic claims, claims meeting reinsurance criteria and complex claims involving significant resolution issues. We are looking for a dynamic team-player with the ability to interact successfully with program members and claim adjusters to build and maintain good working relationships.


Responsibilities Include:

  1. Review assigned cases and develop a medical assessment of the injury, treatment and/or return to work plan; follow up with providers, members and injured workers to assure recovery is progressing properly. Review causal relationship cases, gap in treatment cases, cases involving specialized treatment/testing and committee findings.
  2. Oversee outside vendor files for compliance with standards. Maintain approved rehabilitation provider listing and guidelines and meet with providers to provide WC education and assist with related issues that arise.
  3. Promptly schedule Independent Medical Exams and/or second opinions as requested by claims representative and prepare accurate written summaries and pertinent medical records for physician review; attend medical appointments with injured workers as needed. Negotiate rates of services and/or equipment on assigned files. Assist claims representatives in creating panels for injure worker.

  4.  

    Experience/Knowledge/Skills/Abilities:

    1. Considerable experience in occupational health or rehabilitation in a hospital or industrial setting and a current Registered Nurse license in operational jurisdiction. Must have graduated from an accredited program in Registered Nursing. Certified Case Manager or Certified Rehabilitation Professional is required.
    2. Considerable knowledge of nursing standards of care, accepted practices and a working knowledge of occupation health or rehabilitation standards.
    3. Proficient in the use of personal computers including Microsoft Suite software applications and the use of the internet for business purposes.
    4. • Demonstrated abilities to gather and analyze information and reach sound conclusions; manage transitions back into the workplace; advocate prompt and adequate medical treatment for injured workers; negotiate rate of service; create and maintain hardcopy and complex electronic files including databases; communicate activities between software applications; work effectively with all levels of an organization; maintain confidentiality; meet deadlines and goals and function both independently and as a member of a team.
    5.  

      Qualified candidates may submit a cover letter, including salary requirements and resume, to Human Resources, VML Insurance Programs, P.O. Box 3239, Glen Allen, VA 23258, fax 804-273-0560, or e-mail to hr@vmlins.org, attention: PA www.vmlins.org EOE – We value diversity

      EOE - We Value Diversity