Nurse Utilization – Clinical Analyst, Bilingual Spanish/English

🕒 May 5

🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

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MedRisk

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

🤝 B2B

☁️ SaaS

Healthcare Insurance • B2B • SaaS

MedRisk is a managed care organization that specializes in improving recovery and payment integrity for workers' compensation and occupational injury cases. The company combines clinical triage, scheduling, patient engagement, network management, and analytics to connect patients with appropriate care, streamline authorizations, and deliver secure electronic payments. MedRisk provides services and technology platforms for payers, providers, and patients to optimize spending, ensure compliance, and translate data into actionable insights.

📋 Description

• Develop and maintain effective professional relationships with medical providers, claims adjusters and clients • Demonstrate excellence in communications to ensure customer satisfaction and retention • Demonstrate basic problem-solving skills to ensure early intervention and identification of injuries • Direct recommended care into network providers • Follows up on injury status • Accurately and completely documents in file using standard documentation format(s) • Follows all standards, procedures, and protocols • Maintains overall QA average of 95% • Participates in departmental projects and meetings

🎯 Requirements

• Active and unencumbered registered nursing license • Two years clinical nursing experience • Primary RN license must be compact license • Occupational medicine, ED or UC experience desirable • CA nurse licensure is mandatory • Strong organizational and time management skills • Ability to multitask • Knowledgeable in computer operations • At least 30 to 40 WPM typing speed required • Must possess excellent oral communication/telephone skills • Must demonstrate the ability to understand state laws and guidelines

🏖️ Benefits

• Clinical Advisor Services Analyst is responsible for performing telephonic assessments of work-related injuries • Conducts telephone assessments of work-related injuries/illness