Utilization Review Nurse

🕒 2 days ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $63k - $65k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏢 Enterprise

📋 Compliance

Insurance • Enterprise • Compliance

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Utilize evidence-based tools to evaluate the prescribed treatment to ensure patient safety and quality standards • Perform clinical assessments via information in medical files • Assess injured employee’s situation which may include psychosocial needs • Evaluate patient condition including treatment utilization and compliance • Collaborate effectively with physicians, claims examiners, clients, vendors, supervisors and other parties as needed • Negotiate appropriate level and intensity of care through use of medical and disability guidelines • Maintain client's privacy and confidentiality; promote client safety and advocacy; adhere to ethical, legal, accreditation and regulatory standards

🎯 Requirements

• Active unrestricted RN license in a state or territory of the United States required • Compact licensure preferred • Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred • Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred • Two (2) years of direct clinical experience as an RN is required

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • 401K • Paid time off • Employee assistance program • Flexible spending or health savings account • Continuing education credits • Team building initiatives