Utilization Review Nurse for Workers' Comp Office Location - Montgomery County Area Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. **Please note that this is an In-office position. Duties: Perform an evaluation of the medical data for utilization review requests. Confirm accurate completion of data intake. Collect additional relevant data as needed with regard to determining medical necessity. Analyze the collected data to apply evidence-based guidelines. Review requests and make certification decisions, when appropriate, or prepare a case for peer review referral. Coordinates information between all parties (injured worker, physicians, employer, therapists, attorney, etc) Participate in audits of work product to ensure compliance. Monitor daily processing inventory, including rush/urgent requests. Provide inventory information and raise concerns to clinical director. Complete production logging. Assist leadership team with training and coordinating back-up resources. Requirements/Skills/Qualifications: Graduate of an accredited school Valid current RN license in good standing Able to perform the professional and technical skills of a Registered Nurse Minimum 2 years of direct patient care Excellent, written and oral communication skills Ability to read and interpret medical reports and treatment guidelines Must be able to maintain confidentiality Must possess strong personal organizational skills Must have experience and knowledge of intermediate computer skills Ability to work independently with little to no supervision Ability to work in a fast-paced and time-sensitive environment Ability to meet deadlines in a production driven environment Ability to work with WORD and EXCEL documents. Preferences: Experience in Utilization Review, Workers Compensation is a plus Elite Services
Information Operations Planner Location: Metro Park - Alexandria, VA Work Type: Onsite Remote Work: No Qualifications Formal Information Operations (IO) or Information Related Capability (IRC) training. IRCs include Psychological Operations (PSYOP) / ...
Commercial Construction Superintendent Centrex Construction Position Overview The primary responsibility of a Superintendent at Centrex is to ensure the project is staying on track to line up with the completion date by monitoring the subcontractors, deliveries...
...Join our caring team as a Medical Social Worker, where you'll support patients and families in... ...A solid educational foundation in social work, often a Bachelors or Masters degree in... ...~ Flexible working hours ~ Work-from-home options ~ Mobile and communication allowance...
...Lead Custodian, maintain cleanliness and proper operation of the buildings and grounds of the Bluestem facility. Complete scheduled cleaning and preparation duties as assigned. Be vigilant of the needs of Trollwood Performing Arts School, and assist in moving equipment...
...A private practice in Houston Heights looking for a dental front office administrator to join our team. This is an entry-level position, but please do NOT apply if you do not have any dental experience. Requirements: Applicants should have a minimum of 6 months...