• Job Description

  Req#: 3426319

  Do you have a passion for healthcare, but prefer to use your clinical skills in a non-clinical setting? Do you enjoy piecing together and analyzing information? Do you enjoy engaging in computer-based tasks, and navigating between multiple screens? Then consider a position as a Utilization Review Healthcare Professional with EK Health! As an Health Care Professional, you will play a critical role in assessing the medical necessity and appropriateness of healthcare services, ensuring the efficient utilization of resources, and optimizing patient outcomes. If you have a background in healthcare, exceptional analytical skills, and a passion for improving healthcare delivery, we invite you to apply for this rewarding position!

  
  

  This position requires one of the following certifications: RN, DC, PT, DPT, LVN, OT, Lac.

  
  

  Position Logistics: Non-Exempt, Full-time, Monday – Friday, 8-hour workdays, between 8:30am – 6:00 pm Pacific Standard time, remote. Candidates can reside in any state with the exception of : CA, NY, HI, DC.

  
  

  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 authorization, 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

  Highlights include:

  • Monday-Friday schedule during normal work hours (no weekends or holidays!)
  • Excellent orientation and training program
  • Woman and minority owned business
  • Caring, family environment

  Pay & Benefits:

  • Starts at $30/hour based on experience, education, and certifications.
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401K
  • Paid Time Off
  • Paid holidays

  EK Health Services Inc. is a leading national workers’ compensation managed care organization. EK Health restores quality of life for injured workers through innovative, cost-effective solutions. Our holistic approach integrates the best people, processes, and technology to facilitate the best medical treatment available for return-to-work possibilities. Consider a career with EK Health!

  
  

• About the company

  EK Health has built a reputation for offering superior, goal-oriented services to Workers' Compensation and Liability clients through its team of highly skilled clinical staff and executives with training and significant experience in managed care, lea...

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