Utilization Review Health Care Professional (PT, LVN, LPN) - REMOTE

extra holidays - extra parental leave
Work set-up: 
Full Remote
Contract: 
Experience: 
Entry-level / graduate
Work from: 

Offer summary

Qualifications:

Graduate of an accredited medical program such as nursing, chiropractic, or related fields., Valid state-specific license in the appropriate scope of practice, in good standing., At least 1 year of clinical experience., Proficiency with computers and common software like MS Word and Excel..

Key responsibilities:

  • Assess medical data to determine necessity of healthcare services.
  • Communicate and coordinate with healthcare providers, insurance, and patients.
  • Analyze data to ensure compliance with evidence-based guidelines.
  • Participate in audits and maintain professional communication with all stakeholders.

EK Health Services Inc. logo
EK Health Services Inc. SME https://www.ekhealth.com/
201 - 500 Employees
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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


Required profile

Experience

Level of experience: Entry-level / graduate
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Communication
  • Analytical Skills
  • Computer Literacy
  • Social Skills
  • Organizational Skills

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