Nurse Planner

Are you are RN and passionate about healthcare? Do you want to contribute to a dynamic, values-oriented workplace? If so, you’ll fit right in with the team at ExamWorks Clinical Solutions (ECS).

The Nurse Planner works autonomously to develop any and/or all of the following:  Life Care Plans, Medical Cost Projections, Limited Medical Cost Projections, Medicare Set-Aside Allocations, Legal Nurse Reviews, Complex Nurse Reviews, Bill Reviews and other reports as needed within their scope of licensing and certifications.

This is a full-time position, Monday-Friday, 8am-5pm. 

ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM THIS JOB SUCCESSFULLY INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING:

• Collects, reviews and analyzes health data from medical records and/or other sources as provided.

• Identify future medical needs utilizing medical standards of care and guidelines, in addition to historical trend of care.

• Work autonomously and collaborates with all company personnel as needed; including communicating with the accounts and attorneys as needed.

• Maintain a quality work product evidenced by acceptable quality scores/score cards.

• Participate in company orientation, management meetings and/or conference calls as required to improve self-knowledge and/or for the improvement of the company.

• Attend all scheduled conference calls as mandated by management.

• Maintain any required credentials and adhere to all codes of ethics required by these credentials.

• Ensures all federal Centers for Medicare and Medicaid Services (CMS) requirements and/or state mandates are adhered to at all times.

• Provides insight and direction to management on report quality and compliance with all company policies and procedures, client specifications, URAC and CMS guidelines.

• Promote effective and efficient utilization of company resources.

• Participate in various educational and or training activities as required.

• Perform professional duties as assigned by the Manager or upper management.

ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM THIS JOB SUCCESSFULLY INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING:

• Collects, reviews and analyzes health data from medical records and/or other sources as provided.

• Identify future medical needs utilizing medical standards of care and guidelines, in addition to historical trend of care.

• Work autonomously and collaborates with all company personnel as needed; including communicating with the accounts and attorneys as needed.

• Maintain a quality work product evidenced by acceptable quality scores/score cards.

• Participate in company orientation, management meetings and/or conference calls as required to improve self-knowledge and/or for the improvement of the company.

• Attend all scheduled conference calls as mandated by management.

• Maintain any required credentials and adhere to all codes of ethics required by these credentials.

• Ensures all federal Centers for Medicare and Medicaid Services (CMS) requirements and/or state mandates are adhered to at all times.

• Provides insight and direction to management on report quality and compliance with all company policies and procedures, client specifications, URAC and CMS guidelines.

• Promote effective and efficient utilization of company resources.

• Participate in various educational and or training activities as required.

• Perform professional duties as assigned by the Manager or upper management.