This is a great way to use your LVN/LPN or Physical Therapist license in a non-clinical setting!

EK Health - a national Workers Compensation Case Management Company - is now hiring for a Utilization Review Healthcare Professional for its Rocklin, CA office. Utilization Review is a great way to use your critical thinking and analytical skills along with your LVN/LPN/PT certification! EK Health will train on the Utilization Review process.

Utilization Review is a collaborative process to promote quality cost effective outcomes, which enhance the health of individuals. The Health Care Professional provides technical and clinical knowledge to the field of utilization management to assess the medical necessity of provider requests for services. Here are some of the responsibilities:

• 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
• 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
• Coordinates information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any are involved)
• 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

This position is located at our Rocklin, CA office, and is Mon-Fri between the hours of 8AM - 6:00 PM (8 hour day)

This position starts at $30-32/hr, and is based on experience in Utilization Review, education, and certification. We offer excellent employee benefits, including Medical, Dental and Vision Insurance, 401K, PTO and up to 7 paid holidays.

Here are the requirements for this position:

• 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 restrictions
• Possesses and can demonstrate the professional and technical skills required
• Experience in UR, Workers' Compensation experience highly preferred, but not required
• Excellent Written and Oral Communication Skills
• Excellent Interpersonal Skills
• Strong Organization Skills
• High comfort level with computers and computer programs (MS Word, MS Excel, Email)
• Ability to work independently with minimal supervision
• Ability to meet deadlines in a high pressure, time sensitive environment
• Ability to lift up to 20 lbs.