PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Office of the State Treasurer, Second Injury and Assurance Fund, this class is responsible for managing, directing, implementing and monitoring programs involving medical cost containment and disability management relating to occupational injuries and loss control matters.
Works under the general supervision of a Supervising Nurse Consultant or other employee of higher grade.
May supervise/lead professional and clerical staff as assigned.
EXAMPLES OF DUTIES
Implements, coordinates, and evaluates activities of assigned programs or health care services; maintains active liaison with and serves as nursing consultant to other sections, divisions, health care providers and public; may inspect and evaluate health care and psychiatric facilities for compliance with state and federal regulations including licensure and certification laws; assesses safety and quality of client care provided; assesses compliance of health insurance companies with various state statutes, regulations and guidelines; performs related duties as required.
Reviews, audits, monitors and directs in areas of medical management, cost containment, peer review and rehabilitation; monitors agency and third party administrators and medical community to develop effective programs in medical management and loss control; analyzes medical and physician charges and renders decisions regarding rehabilitative planning for assigned cases; evaluates personal injuries in terms of physical disability and incurred costs as result of medical bills, wage replacement or vocational rehabilitation; develops cost effective plans to return injured workers to employment; identifies and evaluates factors within claimant home; work environment or medical care center that would promote recovery or give cause to unnecessary extended disability; develops plans of cost effective means of treatment and rehabilitation to return injured workers to maximum functioning capacities; coordinates efforts of physicians, employers, employees and rehabilitation counselors; monitors medical bill costs and evaluates need for billed services; monitors and assists in management of lifetime care of catastrophically injured claimant; performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY
Considerable knowledge of State of Connecticut Workers Compensation statutes, rules and regulations; considerable knowledge of care and service delivery to injured workers; considerable knowledge of relevant State and Federal laws, statutes and regulations; considerable knowledge of principles and practices of nursing care administration and education for a variety of specialties with varied settings; considerable knowledge of principles and practices pertinent to community processes; knowledge of State, Federal and local health agencies and programs; knowledge of nursing education and skill in techniques of teaching; considerable interpersonal skills; oral and written communication skills; ability to plan, implement and evaluate programs; ability to collect and analyze data.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Four (4) years of experience as a professional nurse in a position involving supervision, consultation, education, or administration in rehabilitative nursing with injured workers, including medical review of insurance claims.
MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED
1. A Bachelor's degree in nursing may be substituted for one (1) year of the General Experience.
2. A Master's degree in health services administration, nursing or public health may be substituted for one (1) additional year of the General Experience.
1. Incumbents in this class must possess and retain a current license as a registered professional nurse in Connecticut.
2. Incumbents in this class may be required to possess certification as an Insurance Rehabilitation Specialist or be eligible for certification as an Insurance Rehabilitation Specialist.
3. Incumbents in this class may be required to travel.
4. Incumbents in this class may be required to possess and retain a valid Motor Vehicle Operator’s license.
1. Administrative capacity shall be interpreted as having managerial responsibility in setting and implementing policies, carrying out program planning, and evaluating and coordinating special projects, etc. in the area specified in the appropriate parenthetical title.
2. Consultative capacity shall be interpreted as the providing of professional expert nursing advice to other than subordinate staff on major programmatic issues in the area specified in the appropriate parenthetical title.
3. Educational capacity shall be interpreted as experience in a full time professional educational position instructing professional nurses in a formalized program or teaching students in an undergraduate or graduate nursing program in the area specified in the appropriate parenthetical title.
4. Supervisory capacity shall be interpreted as the administrative supervision of registered nurses or other professional staff including accountability for hiring, firing, reviewing and evaluating employee performance in the area specified in the appropriate parenthetical title.
JOB CLASS DESIGNATION
(11)-HEALTH PROF (P-1)
This replaces the existing specification for the class of Nurse Consultant in Salary Group HC/FP 28 approved effective September 16, 2016. (Revised to establish a class code for the Department of Children and Families and modify content)