Clinical Nurse Utilization Analyst

MedRisk; Washington (District of Columbia); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare services company is seeking a Clinical Advisor Services Analyst II to work remotely. The ideal candidate must hold an active nursing license and have two years of clinical experience. Key responsibilities include developing professional relationships with medical providers, ensuring customer satisfaction, and maintaining documentation standards. This full-time role is essential for effective triage and care management.

Qualifications

• Two years clinical nursing experience required.
• Compact RN license required, must reside in a compact state.
• Experience in occupational medicine, ED, or UC desirable.

Responsibilities

• Develop and maintain relationships with medical providers.
• Ensure customer satisfaction and retention.
• Document in file using standard formats.

Skills

Organizational skills

Time management skills

Multitasking

Oral communication skills

Education

Registered nursing license

Active CA RN license (or willingness to obtain)

Tools

Windows operating system

Job description

Overview

Clinical Advisor Services Analyst II

Location: Remote (US) • Department: Clinical/Nursing • Job Type: Full Time

Qualifications

• Active and unencumbered registered nursing license with two years clinical nursing experience.
• Primary RN license must be compact license (nurse must have compact license and reside in a compact state).
• Occupational medicine, ED or UC experience desirable.
• CA nurse licensure is mandatory (must hold an active CA RN license or be willing to obtain upon hire - company to reimburse cost).
• Medicine or Rehab experience desirable.
• Strong organizational and time management skills.
• Ability to multitask (type/talk/read simultaneously).
• Knowledgeable in computer operations, including Windows operating system, data entry skills and 10-key capabilities.
• 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.
• Great interdepartmental communication (regularly communicates with intake team).

Responsibilities

• Develop and maintain effective professional relationships with medical providers, claims adjusters and clients.
• Demonstrates excellence in communications to ensure customer satisfaction and retention.
• Demonstrates basic problem-solving skills to ensure early intervention and identification of those injuries which will benefit from medical case management or to deliver self-care advice during the triage process.
• Directs recommended care into network providers as applicable.
• Follows up on injury status, when applicable, to advance level of care when necessary.
• Accurately and completely documents in file using standard documentation format(s).
• Follows all standards, procedures, and protocols.
• Maintains nurse licensure with license in good standing.
• Maintains an overall QA average of 95%.
• Participates in departmental projects and meetings with 80% minimum attendance at meetings.
• Acknowledges and adheres to Stratacare policies and procedures.
• Maintains acceptable attendance and tardiness.