Remote Utilization Management Nurse Jobs in Alaska

General Purpose

The Workers' Compensation Specialist will facilitate and direct all Workers' Compensation processes in accordance with established Legal Risk Department and Industry Recommended Practices.

Essential Duties

• Assure each Providence Affiliated Facility has access to all Recommended Employee Safety and Workers Compensation Programs and they understand how to properly apply:

• Internal Claims investigation, accurate and timely Claims Reporting, First Aid and Triage, Transportation to MPN and RTW programs.

• Initiate contact with injured employees and explain the Workers' Compensation process as it relates to the injured employee.

• Provide an overview of the Insurance Company, Employee's Physician, Employer and the Wellness Manager's roles during the recovery.

• Incorporate all claim information into the Claim File. Accurately and completely, document conversations and maintain an accurate electronic file of communication related to the injured employee's Workers' Compensation claim.

• Assure report claim information and injury reports are accurately and promptly referred to the appropriate insurance carrier.

• Work as professional liaison between operations and claims adjuster

• Assure each facility maintains contacts with treating physician after injured employee's visit obtain work restrictions and information on injured employee's condition and treatment plan.

• Measure and report compliance of clinics with our recommended protocols

• Remain in contact with the injured employee and gather information on the status of the injured employee's health condition. Consult with the employee's physician, nurse case manager, claims adjuster, and project staff to determine if the injured employee is following the treatment plan prescribed by the employee's physician.

• Act as a liaison between the injured employee's physician, insurance company, nurse case manager, management, and employee to gain a timely return-to-work release.

• Maintain communication with the insurance carrier; prepare status reports on critical claims for management.

• Ability to track the status of assigned claims to their successful and timely completion required.

• Ability to organize and prioritize a heavy workload to meet deadlines required.

• Must be trustworthy and can handle highly confidential information with the utmost care and discretion required.

• Work with Broker and Insurer to produce monthly claims reports to Operations.

• Direct monthly internal calls with Facility management, Quarterly claims reviews with Insurer

• Work as Consultant to HR and other PACS staff

• Develop and assist in implementation of Risk Avoidance Programs as necessary

• Accept other assignments as needed.

• Some overnight travel required.

Supervisory Requirements

This position has no direct supervisory responsibilities but does serve as a coach and mentor for other positions within the company.

Qualification (Education and/or Experience)

• Bachelor's degree (B.A.) from a four-year college or university.

• Travel by auto or airline will be required 25% of the time.

• In the office, or remote position, flextime available to work from home.

Physical Demands

• Ability to spend prolonged periods of time standing, speaking, walking, driving, and/or sitting.

• Requires ability to occasionally lift up-to 25lbs.

• Position may require travel: Up to 80% of the time to facility sites.

• Reasonable accommodation may be made to enable individuals with disabilities to perform the essential requirements.

• Essential functions may require maintaining the physical condition necessary for sitting, walking or standing for prolonged periods of time; operating a computer and keyboard; near visual acuity to review written documentation; ability to hear and understand speech at normal room levels and on the telephone.

Join PACS: Elevate Healthcare with Us!

PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide.

If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare!

Join Our Team and Thrive!

At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.

Our Comprehensive Benefits Include

• Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.

• PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.

• Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.

• Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.

• Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.

Join us at PACS and take advantage of a workplace that truly values you!

We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.

Join PACS: Elevate Healthcare with Us!

PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide.

If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare!

Join Our Team and Thrive!

At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.

Our Comprehensive Benefits Include

• Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.

• PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.

• Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.

• Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.

• Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.

Join us at PACS and take advantage of a workplace that truly values you!

We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.