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    RN Utilization Review - Toledo, United States - Sedgwick

    Sedgwick
    Sedgwick Toledo, United States

    3 weeks ago

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    Description


    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague.

    A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.


    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve.

    If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here.

    Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work

    Most Loved Workplace

    Forbes Best-in-State Employer

    RN Utilization Review


    PRIMARY PURPOSE OF THE ROLE:

    To utilize evidence-based tools to evaluate the prescribed treatment to ensure patient safety and quality standards are in alignment with best practice standards.


    ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.


    Apply your RN clinical knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.


    Work in the best of both worlds - a rewarding career making an impact on the health and well-being of others in a remote work environment.


    Enjoy flexibility and autonomy in your daily work and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.

    Enable our Caring Counts mission of supporting injured employees from some of the world's best brands and organizations.

    Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.

    Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.


    ESSENTIAL RESPONSIBLITIES MAY INCLUDE
    Performs clinical assessments via information in medical files; assesses injured employee's situation which may include psychosocial needs.

    Evaluates patient condition including treatment utilization and compliance. Evaluates need for and recommends alternative treatment.

    Collaborate effectively with physicians, claims examiners, clients, vendors, supervisors and other parties as needed.

    Negotiates appropriate level and intensity of care through use of medical and disability guidelines, adhering to quality assurance standards.

    Acts as a resource in consulting with the client, nursing staff and claims examiners regarding treatment issues.

    Performs treatment utilization management reviews.

    Maintains client's privacy and confidentiality; promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.

    We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.


    EDUCATION AND LICENSING
    Active unrestricted RN license in a state or territory of the United States required. Compact licensure preferred. Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred. Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred. Two (2) years of direct clinical experience as an RN is required.

    ​TAKING CARE OF YOU BY

    Seeks innovative customer solutions

    Seeks ongoing learning as a professional and a person

    Thrives when solving challenging problems

    Seeks clear role expectations

    Metrics/policies/processes are helpful

    Seeks to contribute to a larger purpose

    Thrives when everyone is working towards same vision/goals

    Strong team and customer service orientation


    NEXT STEPS
    If your application is selected to advance to the next round, a recruiter will be in touch.

    #nurse

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.


    If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

    You may be just the right candidate for this or other roles.

    Taking care of people is at the heart of everything we do. Caring counts

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions.

    Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions.

    Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts.

    Watch this video to learn more about us. )
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