Utilization Management Nurse, Workers' Compensation
Location: Wausau, Wisconsin
Description: Liberty Mutual is in need of Utilization Management Nurse, Workers' Compensation right now, this position will be ordered in Wisconsin. Detailed specification about this position opportunity please read the description below.
Advance your career at Liberty Mutual Insurance - A Fortune 100 Company!
If you're a registered nurse looking for a new opportunity to work in a fast-paced, profe ssional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. The Utilization Management Nurse performs review services to determine if medical treatment and/or hospitalization are necessary and is delivered in the most appropriate treatment setting. The role negotiates with healthcare providers when medical requests exceed criteria and standards, where allowed by law, and identifies potential alternatives to promote cost effective clinical outcomes. This position provides technical direction on complex treatment requests, appeals, etc.
Responsibilities:
- Conduct recertification, and extensions of utilization review services which may include determinations for inpatient and outpatient admissions, physical, occupational, or chiropractic therapy treatments, diagnostic testing, etc., using nationally recognized criteria and personal clinical experience and medical knowledge. < li> Initiate referrals to Peer Review Services appropriately, and coordinate the services to support the utilization review. Ensure that peer review decisions are communicated within 1-2 business days.
- Perform Utilization Management services within established clinical, productivity, phone and URAC standards. This includes ensuring that an Utilization Management determination is communicated to the provider within two business days of receipt of the medical information or as determined by Worker's Compensation law.
Qualifications:
- 3+ Years of relevant nursing experience
- Degree from an accredited nursing school required, Bachelor of Science in Nursing preferred.
- Current nursing registration required.
- Basic knowledge of states workers' compensation laws, disability management and utilization product review preferred.
- Strong communication and interpersonal skills in order to receive and/or ex change information with healthcare providers, vendors, customers/injured workers, regulatory agencies, and legal professionals.
- Good negotiation skills to effectively establish target return to work dates.
This position is office-based in either our Tampa, Wausau, or Syracuse area office. Candidates outside of regular commuting distance to one of these offices/those seeking 100% work from home will not be considered.
Benefits:
We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits
Overview:
At Liberty Mutual, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense o f humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.
We’re dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Liberty Mutual.
Job: Nursing & Medical
Primary Location: United States-Wisconsin-Wausau
Schedule: Full-time
Salary: $65,300-$81,600
Education Level: Associate's Degree/College Diploma (±13 years)
Travel: Yes, 10 % of the Time
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If you were eligible to this position, please give us your resume, with salary requirements and a resume to Liberty Mutual.
See school teacher resume format sample here.
Interested on this position, just click on the Apply button, you will be redirected to the official website
Apply Utilization Management Nurse, Workers' Compensation Here
This position will be opened on: Wed, 02 May 2018 14:09:14 GMT
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