Out-of-state on-site nurse case management services to be provided to injured employees who receive treatment outside of the state of North Dakota. Out-of-state nurse case managers (OOS NCM) must be registered nurses licensed in the jurisdiction where the case management services are provided. All out-of-state case management referrals will be assigned to a Workforce Safety & Insurance nurse case manager (WSI NCM) initially. The WSI NCM will manage the claim telephonically and request full or limited assignments through the vendor, as appropriate. The vendor shall communicate with injured employees, medical providers, employers, Workforce Safety & Insurance staff, and others regarding medical treatment planning, functional capabilities, and related issues. Additionally, the vendor shall coordinate care to assist in optimal recovery that returns injured employees safely to employment in a timely manner. The duties of the OOS NCM will include contacting the parties within two business days, conducting an initial evaluation of the claim, completing action planning, attending medical appointments, providing all medical documentation to the purchasing agency, coordinating home care or nursing home care, as appropriate, coordinating transitional work with the employer of injury, and assisting the purchasing agency with management of catastrophic or complex workers’ compensation claims.
