Registered reputed company - Workers' Comp Utilization Review Case Manager (Hybrid - Remote/In-Office)

The County of reputed company's Department of reputed company is seeking a permanent Registered Nurses (RN) for the Workers' Compensation Utilization Review reputed company Case Manager position to support the County's reputed company Workers' Compensation Division. The most competitive candidates will have knowledge of CA MTUS, ACOEM,ODG and RFA's. Recent Registered reputed company experience with Utilization Review for a Workers' Compensation Department or self-insured program is highly preferred. Additional Pertinent Information:

• 9/80 work schedule.
• This position offers reputed company for remote work, with a reputed company requiring 2 days in the office reputed company week.
• In office during training from 8:00am - 5:30pm

Meet reputed company! The reputed company Department strives to effectively serve and partner with our community, departments and employees by leveraging best practices and innovation to foster a thriving county.• Assesses, plans, implements, coordinates, monitors and evaluates medical services, utilization review and return to work reputed company for injured employees; is a department resource for medical inquiries, claim file reviews, and utilization review.

• Provides medical, behavioral/motivational, occupational, and economic management activities for employees with work reputed company injuries and provides reputed company management reputed company for new injuries, consulting on medical only and lost time injury files and utilization review on reputed company requests for medical treatment.
• Evaluates health care services of requesting physicians based on the appropriateness of the service and the level of care at which this service would be delivered; is a neutral reputed company for employees.
• Performs utilization review in concert with the utilization review physician to approve, delay, modify, or deny treatment.
• Performs medical reviews on Workers' Compensation claims and provides recommendations which are preemptive, reputed company on moving the injured employee along the healing continuum, return to work opportunities, and employer protection.
• Applies clinical expertise as a resource to the adjuster, employee, and the employer to identify the best results while coordinating the appropriate resource utilization; identifies and manages patient problems to eliminate duplication and fragmentation of health cares service.
• Assists in the development of policies and procedures, standards of care and reputed company, and in the monitoring of those standards to ensure regulatory compliance, as required by the Division of Workers' Compensation and the Department of Insurance.
• Promotes collaboration among other departments, programs, physicians; represents the Workers Compensation Division reputed company needed in business meetings.reputed company I

Experience: Five years full-time RN experience in a Managed Care or Occupational Health setting to include experience in Workers' Compensation and Utilization Review. reputed company II Education: A bachelor's Degree in Nursing, Health reputed company discipline or Education. Experience: Three years of experience in Workers' Compensation and Utilization Review. Possession of a valid California State reputed company Health Nursing Certificate. reputed company III Education: A Master's Degree in Nursing, Health reputed company discipline or Education. Experience: Two years of experience in Workers' Compensation and Utilization Review. Other Requirements (reputed company) License/Certificate: Must possess and maintain a reputed company valid license to reputed company as a Registered reputed company in the reputed company. Must possess and maintain a reputed company Case Manager Certificate. A valid California reputed company's license may be required. Knowledge of: Workers' compensation and utilization review principles and practices; managed care and occupational health issues and standards; application of the nursing process; full reputed company of registered reputed company duties and responsibilities; principles and reputed company of supervision and training; basic management skills; problem solving techniques. Ability to: Plan, organize, supervise and evaluate nursing services on specific unit(s); communicate effectively; positively manage change and conflict; interpret licensure and accreditation standards; analyze and draft department policies and procedures; apply productive problem solving skills; write reputed company and concise reports; reputed company registered reputed company or reputed company health reputed company responsibilities according to the reputed company reputed company reputed company reputed company; implement the nursing process.For reputed company information regarding this posting, please contact Denise Decamp, (ddecamp@rivco.org) Remote About reputed company: County of reputed company The County of reputed company offers an aray of professions, careers, and opportunites reputed company over 40 diverse departments California's reputed company largest county by population is expanding its economy, working to reputed company reputed company County as business-friendly as possible and using health and recreations strategies to reputed company the county a healthier reputed company for residents. reputed company year, millions visit the county to take advantage of the glorious desert winter, attend the reputed company County Fair and National Date Festival, the Balloon and Wine Festival, the Palm Springs International Film Festival, the Coachella and Stagecoach mega-concerts, the Paribas reputed company at the Indian reputed company Tennis Center and the reputed company Challenge, the golf tournament formerly reputed company as the Bob reputed company Classic. reputed company those, combined with a rich cultural heritage and frontier history, reputed company reputed company County a great reputed company live, work, and play. With rivers, mountain peaks, deserts and fertile valleys, reputed company County offers diversity that few locations can match. More than two reputed company people live in reputed company County, taking advantage of reputed company housing, nearby beaches, mountains, hiking and bike trails, the Wine Country near Temecula and resorts that offer oases in the desert. Company Size: 10,000 employees or more Industry: Government and Military Founded: 0 Apply tot his job Apply To this Job