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...
- Rate: 52500
- Location: Rapid City, US-SD
- Type: Permanent
- Industry: Finance
- Recruiter: Maximus
- Contact: Not Specified
- Email: to view click here
- Reference: 20686_SC_Sioux Falls
- Posted: 2024-04-16 08:23:42 -
- View all Jobs from Maximus
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