Utilization Review Nurse

Job description

WHAT WE'RE LOOKING FOR: We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent position within our Medical Management team and that will allow experienced nurses to put their years of clinical knowledge to use in an office environment and learn new skills in this growing industry. No UR experience required! ESSENTIAL RESPONSIBILITIES: - Review complex workers compensation medical treatment requests to ensure accordance with evidence-based medical treatment guidelines, which are generally recognized by the national medical community and are scientifically based. - Research claim file in relation to the requested medical treatment while interpreting medical reports/claims summaries and applies appropriate established guidelines to requested treatment. Refers treatment requests, which do not meet guidelines, for peer review and determination. - Advocate for the injured worker and claims department, ensuring proposed treatment requests are appropriate for the diagnosis. - P...