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Utilization Review Nurse

Employer
CorVel Corporation
Location
Central Islip, New York
Salary
Not Specified
Closing date
Feb 15, 2019

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Category
Health and Medical
Job Type
Full Time
Career Level
Not Specified

Job Details

This role can be worked remotely but the individual must posses NY RN licensure. The U.R. Nurse gathers demographic and clinical information on prospective, concurrent, and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay.

REQUIRED EDUCATION/TRAINING

Must be currently licensed as a Registered Nurse in the state of employment with a minimum of 4 years clinical experience. Must be computer literate.

PREFERRED EDUCATION/TRAINING

The Utilization Review Nurse should have a minimum of an Associate Degree in Nursing and have a thorough knowledge of both C.P.T. and I.C.D.9 codes. Previous experience in the following areas is beneficial:

  • prospective, concurrent and retrospective utilization review.
  • experience in the clinical areas of O.R., I.C.U., C.C.U., E.R., orthopedics.
  • knowledge of worker's compensation claims.
  • Outpatient utilization review.

ESSENTIAL JOB DUTIES

  • The Utilization Review Nurse must identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client.
  • Must collect data and analyze information to make decisions regarding certification or denial of treatment. Work must be completely documented.
  • Requires regular and consistent attendance.
  • Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
  • Additional duties as required.

Application Instructions:

In order to provide equal employment and advancement opportunities to all individuals, employment decisions at CorVel will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law. Please be aware that CorVel generally does not review all applications submitted in response to job openings posted on the Internet because of the large volume of responses. Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.

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Company

CorVel is looking for passionate, motivated individuals to join our team of associates and help us be successful by making a positive impact within our organization and for our clients. If you are interested in joining CorVel, review our available opportunities and submit your resume as indicated by the application instructions.

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