Workers' Comp Utilization Management/Complex Case Management Nurse
Injury Management Organization, Inc
Are you a Registered Nurse seeking a rewarding change in your career? Join our team at Injury Management Organization, Inc. as a Workers' Compensation Utilization Review Nurse in Plano, TX. This hybrid position allows you to utilize your clinical expertise while making a significant impact on the lives of injured workers.
Embrace the opportunity to apply evidence-based guidelines to promote effective treatment plans in a collaborative environment focused on excellence. With a competitive salary ranging from $67,000 to $73,000, you will not only enhance your professional skills but also contribute to a culture grounded in integrity and empathy. Our forward-thinking organization values teamwork and accountability, ensuring you feel engaged and valued in your role. You will have benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Health Savings Account, Competitive Salary, Paid Time Off, and Snack/Drink Room. Don't miss the chance to take your nursing career to new heights while working with a dedicated team passionate about making a difference in the Health Care industry.
Who are we? An Introduction
IMO is a trusted managed care partner for both private and public enterprise with vast experience in quality case management and positive injured employee outcomes. For over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees, a goal that has allowed IMO to grow from Texas into multiple other states including Arkansas, Oklahoma, and New Mexico.
Day to day as a Workers' Comp UR Nurse
In the role of Utilization Management and Complex Case Management Nurse at Injury Management Organization, Inc., you will be responsible for reviewing medical treatment records of patients with work-related injuries. Utilizing your expertise as a Registered Nurse, you will make clinical determinations in accordance with the Official Disability Guidelines (ODG) criteria, ensuring adherence to evidence-based guidelines in establishing medical necessity for services requiring preauthorization. You will efficiently process requests from health care providers and injured employees, aligning with the regulations set forth by the Texas Department of Insurance.
This position allows you to blend your clinical knowledge with critical decision-making skills, all while contributing to the well-being of injured workers and helping them navigate their recovery journey. Join us in a role that values accountability, integrity, and teamwork, all within a flexible and customer-focused environment.
What you need to be successful
To thrive as a Utilization Management and Complex Case Management Nurse at Injury Management Organization, Inc., candidates should possess a valid RN license in accordance with the Texas Board of Nursing and have at least five years of relevant experience in Utilization Management/Complex Case Management and Workers' Compensation, which may include Orthopedic nursing, prior Utilization Review roles. Group Health experience is required. Bilingual proficiency in Spanish and English is preferred to enhance communication with diverse clients. Successful candidates will demonstrate a strong understanding of state-regulated guidelines and mandated timeframes, ensuring compliance with Texas Workers' Compensation rules. Familiarity with CPT and ICD-10 codes, along with medical terminology, is essential for reviewing treatment records accurately.
Additionally, candidates must exhibit excellent critical thinking, sound judgment, and assessment skills to make precise clinical determinations. Proficiency in computer technology, including various software tools, is vital for efficiently processing requests and maintaining updated knowledge in the field. This role seeks dedicated individuals committed to excellence and accountability. Once training is completed, successful applicant will be eligible for hybrid work, 2 days in office/3 days at home office.
Knowledge and skills required for the position are:
So, what do you think? If you can meet these requirements and perform this job as described above, we would be happy to have you as part of our team!
Once an offer has been extended and accepted, the successful applicant will be required to undergo a background and drug screen.
Embrace the opportunity to apply evidence-based guidelines to promote effective treatment plans in a collaborative environment focused on excellence. With a competitive salary ranging from $67,000 to $73,000, you will not only enhance your professional skills but also contribute to a culture grounded in integrity and empathy. Our forward-thinking organization values teamwork and accountability, ensuring you feel engaged and valued in your role. You will have benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Health Savings Account, Competitive Salary, Paid Time Off, and Snack/Drink Room. Don't miss the chance to take your nursing career to new heights while working with a dedicated team passionate about making a difference in the Health Care industry.
Who are we? An Introduction
IMO is a trusted managed care partner for both private and public enterprise with vast experience in quality case management and positive injured employee outcomes. For over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees, a goal that has allowed IMO to grow from Texas into multiple other states including Arkansas, Oklahoma, and New Mexico.
Day to day as a Workers' Comp UR Nurse
In the role of Utilization Management and Complex Case Management Nurse at Injury Management Organization, Inc., you will be responsible for reviewing medical treatment records of patients with work-related injuries. Utilizing your expertise as a Registered Nurse, you will make clinical determinations in accordance with the Official Disability Guidelines (ODG) criteria, ensuring adherence to evidence-based guidelines in establishing medical necessity for services requiring preauthorization. You will efficiently process requests from health care providers and injured employees, aligning with the regulations set forth by the Texas Department of Insurance.
This position allows you to blend your clinical knowledge with critical decision-making skills, all while contributing to the well-being of injured workers and helping them navigate their recovery journey. Join us in a role that values accountability, integrity, and teamwork, all within a flexible and customer-focused environment.
What you need to be successful
To thrive as a Utilization Management and Complex Case Management Nurse at Injury Management Organization, Inc., candidates should possess a valid RN license in accordance with the Texas Board of Nursing and have at least five years of relevant experience in Utilization Management/Complex Case Management and Workers' Compensation, which may include Orthopedic nursing, prior Utilization Review roles. Group Health experience is required. Bilingual proficiency in Spanish and English is preferred to enhance communication with diverse clients. Successful candidates will demonstrate a strong understanding of state-regulated guidelines and mandated timeframes, ensuring compliance with Texas Workers' Compensation rules. Familiarity with CPT and ICD-10 codes, along with medical terminology, is essential for reviewing treatment records accurately.
Additionally, candidates must exhibit excellent critical thinking, sound judgment, and assessment skills to make precise clinical determinations. Proficiency in computer technology, including various software tools, is vital for efficiently processing requests and maintaining updated knowledge in the field. This role seeks dedicated individuals committed to excellence and accountability. Once training is completed, successful applicant will be eligible for hybrid work, 2 days in office/3 days at home office.
Knowledge and skills required for the position are:
- Must have and maintain a valid RN license in accordance with the Texas Board of Nursing
- At least 5 years' experience working in the area of Workers' Compensation and Complex Case Management
- REQUIRES Utilization Review/Preauthorization experience
- Complex Case Management
- Group Health experience required
- Prefer Bilingual Spanish/English
- Maintains current knowledge and requirements as related to Texas Workers' Compensation rules
- Utilizes critical thinking and applies sound judgment and assessment skills for decisions
- Excellent computer/technology skills
So, what do you think? If you can meet these requirements and perform this job as described above, we would be happy to have you as part of our team!
Once an offer has been extended and accepted, the successful applicant will be required to undergo a background and drug screen.
JOB SUMMARY
Workers' Comp Utilization Management/Complex Case Management Nurse
Injury Management Organization, Inc
Plano
7 hours ago
N/A
Full-time
Workers' Comp Utilization Management/Complex Case Management Nurse