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

Description Please note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), or Hawaii (HI). EK Health Has multiple openings for this role!! 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 AssessmentPerform a complete evaluation of the medical data for the requestCollect additional relevant data as needed to decide on medical necessityAnalyze the collected data to determine medical necessity as per evidence-based guidelinesPlanningDiscuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation as neededUpon determination, provide notification of decision to provider, requester, claimant, carrier, and all other parties as mandated by lawImplementationCoordinates information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any are involved)EvaluationParticipate in annual audits of work product to ensure complianceProfessional interaction with EKHS staff, members of the medical community, and all customers of EKHS; both in oral and written formsAll work is done within the scope of practice of an RN, DC, PT, DPT, LVN, OT, or LAcParticipate in teleconferences and staff meetings/trainings as scheduledOther duties as assigned Pay & Perks Pay: $30-35/hr DOE (license, experience, location)Medical, Dental and Vision insurance401KPaid Time OffPaid HolidaysMonthly Internet Stipend Requirements Requirements: Graduate of an accredited school of nursing, chiropractic, or another related medical program (RN, DC, PT, DPT, LVN, OT, LAc)Valid state-specific license in the appropriate scope of practice in good standing with no restrictionsPossesses and can demonstrate the professional and technical skills requiredExperience in UR, Workers' Compensation experience highly preferred, but not requiredExcellent Written and Oral Communication SkillsExcellent Interpersonal SkillsStrong Organization SkillsHigh comfort level with computers and computer programs (MS Word, MS Excel, Email)Ability to work independently with minimal supervisionAbility to meet deadlines in a high pressure, time sensitive environmentAbility to lift to 20 lbs. Physical Requirements: Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant. Requires DSL, fiber, or cable internet connection from home 100 Mbps preferred or better *