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MedRisk

Nurse Utilization-ClinicalAnalyst (Bilingual Spanish/English)

Reposted 6 Days Ago
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Remote
Hiring Remotely in United States
Junior
Remote
Hiring Remotely in United States
Junior
The Nurse Utilization-Clinical Analyst conducts telephonic assessments for work-related injuries, providing treatment recommendations and developing relationships with clients and medical providers.
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 *** Applicants must be Bilingual Spanish/English****

Clinical Advisor Services Analyst II

Location:  Remote (US)

Department: Clinical/Nursing

Job Type:  Full Time


 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.

 


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