Medical Nursing Consultant (Remote)

Description & Requirements

Maximus is currently hiring for a Medical Nursing Consultant to support the Independent Medical Review (IMR) project.

This is a full-time position that is fully remote and can be located anywhere in the United States.

Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.

- Review, organize and identify all medical records provided for CA workers comp cases.

Monitor timeliness of reviews to ensure applicable standards are met.

- Consistently meet production and quality standards.

- Perform special projects as assigned such as legal research, general medical research, etc.

- Work on special projects to improve CA IMR project or other special projects as assigned.

- Become a subject matter expert (SME) using job aides and learning tools.

Minimum Requirements

Minimum Requirements:
- Bachelor's degree with 3-5 years of experience consulting within designated function.

- Graduate of an accredited nursing program

- 1+ year of related experience in the medical/healthcare field

- Active, unrestricted RN or LPN Licensure is required.

- Proficient understanding and experience with Microsoft products; Word, Excel, PowerPoint, Outlook required.

- Ability to quickly learn and proficiently use multiple project-related computer applications.

- Ability to multi-task and quickly adapt and perform in a fast-paced, production-based work environment.

- Ability to work as a team member, as well as independently.

- Ability to work with little supervision.

- Excellent organizational, written, and verbal communication skills

Preferred Requirements:

- Bachelor's Degree preferred

- 3+ years of related experience consulting within designated function

- Prior experience in Utilization Management preferred.

- Knowledge of health regulations, guidelines, and coverage issues

- Knowledge of statistical terminology and use of statistics

Home Office Requirements:

- Candidates must have their own cell phone.

- Maximus provides company-issued computer equipment

- Reliable high-speed internet service

- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

- Minimum 5 Mpbs upload speeds

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resi...