Description & Requirements
Maximus is currently hiring for a Medical Nursing Consultant to support the Independent Medical Review (IMR) project.
This is a full-time position that is fully remote and can be located anywhere in the United States.
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review, organize and identify all medical records provided for CA workers comp cases. Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
Minimum Requirements
Minimum Requirements:
- Bachelor's degree with 3-5 years of experience consulting within designated function.
- Graduate of an accredited nursing program
- 1+ year of related experience in the medical/healthcare field
- Active, unrestricted RN or LPN Licensure is required.
- Proficient understanding and experience with Microsoft products; Word, Excel, PowerPoint, Outlook required.
- Ability to quickly learn and proficiently use multiple project-related computer applications.
- Ability to multi-task and quickly adapt and perform in a fast-paced, production-based work environment.
- Ability to work as a team member, as well as independently.
- Ability to work with little supervision.
- Excellent organizational, written, and verbal communication skills
Preferred Requirements:
- Bachelor's Degree preferred
- 3+ years of related experience consulting within designated function
- Prior experience in Utilization Management preferred.
- Knowledge of health regulations, guidelines, and coverage issues
- Knowledge of statistical terminology and use of statistics
Home Office Requirements:
- Candidates must have their own cell phone.
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
