UR Health Care Professional - Workers Compensation (RN, DC, PT, DPT, LVN, OT, or LAc) - REMOTE!

Please note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), or

Hawaii (HI).

UR is a collaborative process to promote quality cost effective outcomes, which enhance the physical, psychosocial, and vocational health of individuals. The HCP applies and provides technical and clinical knowledge and experience to the field of utilization management to assess the medical necessity of provider requests for services. The UR HCP will be able to apply evidence-based guidelines applicable to the jurisdiction for the claim.

Position Logistics: Non-Exempt, Full-time, Monday – Friday, 8-hour workdays, between 8:30am – 5:30 pm Pacific Standard Time, Remote.

Responsibilities may include, but are not limited to:

• Assessment
  • Perform a complete evaluation of the medical data for the request
  • Collect additional relevant data as needed to decide on medical necessity
  • Analyze the collected data to determine medical necessity as per evidence-based guidelines
• Planning
  • Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation as needed
  • Upon determination, provide notification of decision to provider, requester, claimant, carrier, and all other parties as mandated by law
• Implementation
  • Coordinates information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any are involved)
• Evaluation
  • Participate in annual audits of work product to ensure compliance
• Professional interaction with EKHS staff, members of the medical community, and all customers of EKHS; both in oral and written forms
• All work is done within the scope of practice of an RN, DC, PT, DPT, LVN, OT, or LAc
• Participate in teleconferences and staff meetings/trainings as scheduled
• Other duties as assigned

Pay & Perks

• Pay: $30-35/hr DOE (license, experience, location)
• Medical, Dental and Vision insurance
• 401K
• Paid Time Off
• Paid Holidays
• Monthly Internet Stipend