2 professional review nurse jobs found

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Irvine, CA, Scottsdale, AZ or Salt Lake City, UT.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...