Utilization Management Nurse Reviewer

Applied Underwriters•Omaha, NE

1d•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
Various additional quality-of-life benefits