Sr Case Management Specialist - 90300793 - Wilmington

Your success is a train ride away! As we move America’s workforce toward the future, Amtrak connects businesses and communities across the country. We employ more than 20,000 diverse, energetic professionals in a variety of career fields throughout the United States. The safety of our passengers, our employees, the public and our operating environment is our priority, and the success of our railroad is due to our employees. Are you ready to join our team? Our values of ‘Do the Right Thing, Excel Together and Put Customers First’ are at the heart of what matters most to us, and our Core Capabilities, ‘Building Trust, Accountability, Effective Communication, Customer Focus, and Proactive Safety & Security’ are what every employee needs to know and do to be most impactful at Amtrak. By living the Amtrak values, focusing on our capabilities, and actively embracing and fostering diverse ideas, backgrounds, and perspectives, together we will honor our past and make Amtrak a company of the future. Job Summary This role provides active management of Amtrak injured workers from the day of injury through their return to work at Amtrak. This role is the point of contact for the injured worker, the manager, and the medical management team(vendor) and to ensure any one returning to work has the appropriate medical evaluation and clearances or to refer inconsistencies to Sr Manager or Medical Director. This role identifies transitional duty for Amtrak injured workers so that they can return to productive paid employment as they recover from their on-duty-injuries and refers those who are not able to return to their positions to the ADA process. Essential Functions Performs case management for injured workers. Reviews all medical documentation to ensure the employee has been medically released to return to his or her position by the treating doctor without restrictions. Escalates any concerns about fitness for duty to the Corporate Medical Director. Once the Case Manager/SrCase Manager (CM/SCM) has the reviewed the release, they will send the request for the Return to Work(RTW) drug tests to the Return to Work coordinator. Works with the injured workers, the supervisor, the external medical management vendor and treating health care providers to identify when an injured employee may return to work and to facilitate transitional duty where appropriate. Ensures uniform implementation of Right Care Day 1 (RCD1) policies and processes and adherence to HR policies as it relates to leave and return to work. Identifies Transitional Duty assignments where appropriate: Uses clinical knowledge and/or experience to anticipate eligibility for transitional duty (e.g. return to usual position within 90 days). Uses knowledge of Amtrak positions to identify possible alternate work opportunities. Works with supervisors and labor organizations to develop transitional duty assignments within Amtrak, and where possible, with non-profit organizations, for employees who have physical restrictions but are expected to return to duty at their own position within 90 days. Ensures effective communication about injured worker status with appropriate parties: Provides anticipatory guidance to managers and Claim adjustor on duration of employee absence and return to work. Monitors the injured worker’s progress towards maximum medical improvement and performance at transitional duty assignments and coordinated return to full duty with medical providers, supervisors, Amtrak Medical Services and the injured worker. If the injured worker is not able to participate in a transitional duty assignment, the SrCase Management Specialist (SCMS) ensures the employee has been released with no restrictions prior to returning to his or her position. Customer Outreach: Conduct continuous educational training programs with management and their staff to ensure a complete understanding of and support for the program in the field. Assist managers/supervisors in identifying potential transitional duty assignments before the need arises through site visits and consultations. Drives Process Improvements: Develops improvements in case management processes within Amtrak and with the medical management vendor to generate efficiencies, cost savings, and/or improvements in the care of the injured worker, i.e. auditing. Review the Provider Manual distributed to treating providers for updates. Participates in regular meetings with the medical management vendor. Represents RCD1 in process improvement activities with other Amtrak partners (e.g. Claims, System Safety, Leave Management examples). Minimum Qualifications Bachelor’s degree in nursing, vocational rehabilitation, health sciences or related field required or equivalent combination of training, deduction, and relevant experience may be considered in lieu of a degree 3 or more years of prior relevant experience Experience working with injured workers in a medical office or hospital or handling injured workers claims in an ins...