Experience:
3-5 years of experience
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Employment Type:
Full time
Posted:
2/8/2018
Job Category:
Health Care Provider
Industry:
Other
Registered Nurse - RN
(This job is no longer available)
1-888-OHIOCOMP | Cleveland, OH
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Job Description

1-888-OHIOCOMP is currently seeking a Full-Time Utilization Management Nurse for our Cleveland office. Candidates should at least 2 years of clinical experience. Familiarity with Ohio BWC desired but Occupational Medicine and or Orthopedic background helpful. We offer an excellent benefit package, daytime hours, 5 day work week, and a friendly office environment. Looking for team players with excellent communication and computer skills. Effective analytical and problem solving ability.

Duties & Responsibilities:

  • Collaborates with the assigned RN case manager to make determinations on reimbursement of treatment (C-9) requests.
  • Gathers pertinent medical evidence including progress notes, assessments, diagnostic test results, BWC and industrial commission orders, ect., needed for the treatment decision making process as it relates to the allowed conditions in the injured worker's (IW's) claim.
  • Obtains file reviews by the MCO medical director for more complex treatment request issues,
  • Communicates and collaborates with providers as needed in the treatment decision process.
  • Documents the clinical rational for the treatment decision
  • Performs job requirements in a manner consistent with the corporate guidelines for ethics in the workplace
  • Maintains knowledge of current BWC policy and procedure

    Qualifications

    Applicants must be eligible to work in the specified location