[Hiring] Nurse Utilization-Clinical Analyst @MedRisk LLC

Role Description

The clinical advisor services analyst II nurse is responsible for performing telephonic assessments of work-related injuries. The nurse will conduct telephone assessments of work-related injuries/illness while utilizing an assessment platform and decision support tool to determine the appropriate treatment recommendation for the injury/illness at hand.

Qualifications

• Active and unencumbered registered nursing license with two years clinical nursing experience.
• Primary RN license must be compact license (nurse must have compact license and reside in a compact state).
• Occupational medicine, ED or UC experience desirable.
• CA nurse licensure is mandatory (must hold an active CA RN license or be willing to obtain upon hire - company to reimburse cost).
• Medicine or Rehab experience desirable.
• Strong organizational and time management skills.
• Ability to multitask (type/talk/read simultaneously).
• Knowledgeable in computer operations, including Windows operating system, data entry skills and 10-key capabilities.
• At least 30 to 40 WPM typing speed required.
• Must possess excellent oral communication/telephone skills.
• Must demonstrate the ability to understand state laws and guidelines.
• Great interdepartmental communication (regularly communicates with intake team).

Responsibilities

• Develop and maintain effective professional relationships with medical providers, claims adjusters and clients.
• Demonstrates excellence in communications to ensure customer satisfaction and retention.
• Demonstrates basic problem-solving skills to ensure early intervention and identification of those injuries which will benefit from medical case management or to deliver self-care advice during the triage process.
• Directs recommended care into network providers as applicable.
• Follows up on injury status, when applicable, to advance level of care when necessary.
• Accurately and completely documents in file using standard documentation format(s).
• Follows all standards, procedures, and protocols.
• Maintains nurse licensure with license in good standing.
• Maintains an overall QA average of 95%.
• Participates in departmental projects and meetings with 80% minimum attendance at meetings.
• Acknowledges and adheres to Stratacare policies and procedures.
• Maintains acceptable attendance and tardiness.