Job Summary

An insurance company is seeking a Remote Workers Compensation Utilization Review Medical Case Manager.

Individual must be able to fulfill the following responsibilities:

• Conduct prospective, concurrent, expedited and retrospective utilization management
• Review all requests for treatment in accordance with preauthorization criteria
• Evaluate treatment requests and review clinical information received with treatment protocols

Required Skills:

• Associate or Bachelor’s degree in Nursing, Master’s level in a Nursing, Health or Human Services field or equivalent
• Current, unrestricted (RN), (LPN) and or (CCM) license required
• Three or more years of diverse clinical experience in acute care
• Two or more years of Utilization Review or Managed Care experience