California Licensed RN Case Reviewer

Job Summary

A company is looking for a Consultant - Medical (RN) Case Reviewer 2.

Key Responsibilities

• Review and summarize WCMSA case submissions, certifying or non-certifying requested treatments
• Provide written clinical rationales for California Workers Compensation cases and ensure compliance with applicable standards
• Monitor review timelines and perform special projects as assigned, becoming a subject matter expert in the process

Required Qualifications

• Bachelor's degree with 3-5 years of relevant consulting experience or equivalent professional experience
• Valid RN licensure is required
• Commitment to a two-week training period and flexibility in work hours post-training
• Extensive medical knowledge, including familiarity with medical terminology and coding systems
• Experience with Medicare Set-Aside arrangements and related healthcare guidelines is preferred