Utilization Management Nurse Reviewer

Applied Underwriters • Omaha, NE

2d • Onsite

About The Position

Workers’ compensation utilization management activities include the review of clinical information to determine medical necessity at all levels of care. You will utilize criteria, or evidence-based guidelines, coordinate of care across the continuum, and interact with physicians, providers, claimants and peer reviewers as part of the utilization management process.

Requirements

• Current and unrestricted RN license in the state of Nebraska or that of a compact state.
• At least 5 years of clinical experience.
• Familiar with utilization review process, case management, and/or discharge planning.
• Proficient using Microsoft Windows, including Word, Excel, Outlook, how to search for files, and create PDFs.
• Ability to utilize template letters, forms, and creating summaries.

Responsibilities

• Review of clinical information to determine medical necessity at all levels of care.
• Utilize criteria, or evidence-based guidelines.
• Coordinate of care across the continuum.
• Interact with physicians, providers, claimants and peer reviewers as part of the utilization management process.

Benefits

• 100% employer-paid medical, dental, and vision insurance for employees
• 401(k) plan with 100% immediate vesting and a 4% company match
• Paid time off (PTO) and paid holidays
• On-site pharmacy, Promesa, provides convenient prescription delivery directly to you
• Life, disability, critical illness and accident insurance
• Employee Assistance Program (EAP)
• Pre-tax Flexible Spending Accounts for health, dependent care, and commuter-related expenses
• Tuition reimbursement
• Fitness reimbursement and various additional quality-of-life benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed