Job Description
Job Type
Full-time
Description
Do you have a passion for healthcare, but prefer to use your clinical skills in a non-clinical setting? Do you enjoy piecing together and analyzing information? Do you enjoy engaging in computer-based tasks, and navigating between multiple screens? Then consider a position as a Utilization Review Healthcare Professional with EK Health! As an Health Care Professional, you will play a critical role in assessing the medical necessity and appropriateness of healthcare services, ensuring the efficient utilization of resources, and optimizing patient outcomes. If you have a background in healthcare, exceptional analytical skills, and a passion for improving healthcare delivery, we invite you to apply for this rewarding position!
This position requires one of the following certifications: RN, DC, PT, DPT, LVN, OT, Lac.
Position Logistics: Non-Exempt, Full-time, Monday – Friday, 8-hour workdays, between 8:30am – 6:00 pm Pacific Standard time, remote. Candidates can reside in any state with the exception of: CA, NY, HI, DC.
- Responsibilities may include, but are not limited to:
- Assessment
- Perform a complete evaluation of the medical data for the request
- Collect additional relevant data as needed to decide on medical necessity
- Analyze the collected data to determine medical necessity as per evidence-based guidelines
- Planning
- Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation as needed
- Upon authorization, provide notification of decision to provider, requester, claimant, carrier, and all other parties as mandated by law
- Implementation
- Coordinates information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any are involved)
- Evaluation
- Participate in annual audits of work product to ensure compliance
- Professional interaction with EKHS staff, members of the medical community, and all customers of EKHS; both in oral and written forms
- All work is done within the scope of practice of an RN, DC, PT, DPT, LVN, OT, or LAc
- Highlights include:
- Monday-Friday schedule during normal work hours (no weekends or holidays!)
- Excellent orientation and training program
- Woman and minority owned business
- Caring, family environment
- Pay & Benefits:
- Starts at $30/hour based on experience, education, and certifications.
- Medical Insurance
- Dental Insurance
- Vision Insurance
- 401K
- Paid Time Off
- Paid holidays
EK Health Services Inc. is a leading national workers’ compensation managed care organization. EK Health restores quality of life for injured workers through innovative, cost-effective solutions. Our holistic approach integrates the best people, processes, and technology to facilitate the best medical treatment available for return-to-work possibilities. Consider a career with EK Health!
- Requirements
- Graduate of an accredited school of nursing, chiropractic, or another related medical program (RN, DC, PT, DPT, LVN, OT, LAc)
- Valid state-specific license in the appropriate scope of practice in good standing with no restrictions
- 1+ years' experience in a clinical setting
- Experience in UR, Workers' Compensation experience highly preferred, but not required
- High comfort level with computers and computer programs (MS Word, MS Excel, Email)
- Excellent Written and Oral Communication Skills
- Excellent Interpersonal Skills
- Strong Organization Skills
Apply Now
Apply Now