Temporary Registered Nurse - Workers' Comp Utilization Review Case Manager

County of Riverside; Riverside (CA); Hybrid; USD 70,000 - 100,000; Full time

Job summary

An innovative county organization is seeking a Temporary Registered Nurse (RN) to support the Workers' Compensation Division. This role offers a unique opportunity to engage in utilization review and manage care for employees with work-related injuries. As part of a dedicated team, you will assess and implement medical services, ensuring effective recovery and return-to-work options. With a hybrid work schedule, you can enjoy flexibility while making a meaningful impact in the community. If you have a passion for nursing and a commitment to excellence, this position is perfect for you.

Qualifications

• Five years of full-time RN experience in Managed Care or Occupational Health.
• Bachelor's Degree in Nursing with three years of Workers' Compensation experience.

Responsibilities

• Assessing and coordinating medical services for injured employees.
• Performing utilization reviews in collaboration with physicians.

Skills

Utilization Review

Workers' Compensation

Managed Care

Nursing Processes

Supervisory Principles

Education

Bachelor's Degree in Nursing

Master's Degree in Nursing

Tools

California RN License

Case Manager Certificate

Job description

Job Opportunity: Temporary Registered Nurse (RN) - Workers' Compensation Utilization Review Nurse Case Manager

The County of Riverside's Department of Human Resources is seeking a Temporary Registered Nurse (RN) for the Workers' Compensation Utilization Review Nurse Case Manager position to support the County's Workers' Compensation Division.

Preferred Knowledge and Experience

Candidates should have knowledge of CA MTUS, ACOEM, ODG, and RFA's. Recent RN experience in Utilization Review within a Workers' Compensation Department or self-insured program is highly preferred.

Additional Information

• 9/80 work schedule.
• Remote work opportunity with a hybrid schedule requiring 2 days in the office weekly.
• In-office during training from 8:00 am to 5:30 pm.

Learn more about the TAP program: https://rc-hr.com/temporary-medical-assignment-program-tapmap

Tap benefits details: https://rc-hr.com/files/users/user81/2024%20TAP%20Flyer.pdf

Meet the Team

The Human Resources Department aims to serve and partner with the community, departments, and employees by leveraging best practices and innovation to foster a thriving county. Responsibilities include:

• Assessing, planning, implementing, coordinating, monitoring, and evaluating medical services, utilization review, and return-to-work options for injured employees.
• Providing medical, behavioral, occupational, and economic management activities for employees with work-related injuries.
• Evaluating healthcare services based on appropriateness and level of care, acting as a neutral advocate for employees.
• Performing utilization reviews in collaboration with physicians to approve, delay, modify, or deny treatments.
• Reviewing workers' compensation claims and providing recommendations focused on recovery, return to work, and employer protection.
• Applying clinical expertise to coordinate resources and eliminate service duplication.
• Developing policies, procedures, standards of care, and monitoring compliance with regulatory standards.
• Promoting collaboration across departments and representing the division in meetings.

Qualifications

Option I: Five years of full-time RN experience in Managed Care or Occupational Health, including Workers' Compensation and Utilization Review.

Option II: Bachelor's Degree in Nursing, Health-Related discipline, or Education, with three years of Workers' Compensation and Utilization Review experience.

Option III: Master's Degree in Nursing, Health-Related discipline, or Education, with two years of relevant experience.

Other Requirements

• Valid California RN License and Case Manager Certificate.
• Possession of a valid California driver's license may be required.

Knowledge of workers' compensation, utilization review principles, managed care, nursing processes, and supervisory principles.

Ability to plan, organize, supervise, communicate effectively, manage change, interpret standards, analyze policies, and perform RN responsibilities according to the California Nurse Practice Act.

For more information, contact Brian Arcinas at [e-mail].