Utilization Review Nurse
CorVel Corporation - Boston, MA

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CorVel New England is looking for a Part Time/ Full Time UR Nurse to join our growing team. Primary responsibilities include: •Responsible for monitoring the appropriateness of medical treatment and necessity for workman compensation injuries with adherence to Massachusetts Department of Industrial Accidents Guidelines. •Responsible for extensive research and application of Massachusetts State guidelines. Proactive approach for effectively dealing with several insurance companies and large volume of workers compensation providers and injured workers, insurers and attorney telephonically in a timely manner CorVel Corporation is an Equal Opportunity Employer. Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes. Please be aware that CorVel generally does not review all applications/resumes submitted in response to job openings posted on the Internet because of the large volume of responses.

Essential Job Duties:
Ideal candidate will possess the following: •Must be licensed clinician (RN) with a current unrestricted license to practice medicine/nursing in MA. In addition, 1-2 years of clinical experience with orthopedic, rehabilitation, neurological, medical/surgical or occupational health preferred •Thorough understanding of medical terminology, , anatomy, physiology and concepts of disease •General knowledge of workers’ compensation, MA DIA Guidelines, medical care, levels of medical care and basic ICD-9, CPT coding •Knowledge of common software programs such as Microsoft Office, Excel •Strong decision making and organizational skills •Excellent written and oral communication skills •Must be able to communicate effectively with medical care providers and reviewing medical records for medical necessity •Documents review information in computer. Communicates results to claims adjustors and medical providers •Detail oriented and flexible, strong analytical skills •Professional demeanor a must

Education/Training Requirements:
Workers Compensation experience a plus

CorVel Corporation - 14 months ago - save job - block
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About this company
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CorVel is a national provider of industry leading risk management solutions to employers, third party administrators, insurance companies...