Come work as a Temporary/Contract Nurse Case Manager where you will have an opportunity to work in a customer focused and dynamic Utilization Review department.
We are seeking a seasoned Nurse Case Manager to work with our Utilization Review team. We anticipate this contract to last 6 – 11 months, with the potential to extend. If you have Workers’ Compensation preauthorization experience, keep reading! This position provides the flexibility to work fully remotely or in our Austin office.
Since 2009, TASB has regularly made the top 10 list in the large-employer category of the Austin Business Journal’s Best Places to Work in Central Texas.
At Texas Association of School Boards, the health and safety of our employees, and members, is our top priority. We have implemented safety measures to prevent the spread of COVID-19 in our facilities. Due to the current pandemic situation, this will operate as a remote position, with occasional office-based meetings.
- Evaluate health care services and requested treatment utilizing accepted standards of practice, treatment guidelines, and written criteria; provide objective clinical decisions based on same.
- Coordinate referrals to physician advisors.
- Meet required time frames for pre-authorization decisions through oral and written responses and maintain compliance with all rules and regulations pertaining to utilization review.
- Participate in claims review, audit and negotiation of fees for workers’ compensation cases.
- Assist with development of clinical criteria and provide input to update current criteria.
- Preserve patient confidentiality and properly handle personally identifiable information (PII) to the extent required by law.
- Identify and alert claims adjusters to files that meet criteria for external case management referral.
- Frequent communication with health care providers, peer review doctors and their staff, claims adjusters, and other staff to ensure timely coordination of quality care.
- Assist claims staff with medical questions/concerns regarding claim files.
- Accurately and timely input information into risk management system and other applications.
- Meet continuing education requirements for licensure.
- Complete preauthorization requests and act as the contact person on assigned internal nurse case management files that may be involved and/or medically complicated.
- Keep current with accepted health care practices through journals, discussions, seminars, in-services and professional Case Management and Utilization Management organizations.
- Current registered nurse or vocational nurse license to practice nursing in the State of Texas
- Minimal two years of clinical nursing experience
- Workers’ Compensation utilization review experience preferred
The TASB Difference
- Convenient staff-supportive amenities like an on-site child care center, mini- market, fitness room, and more.
- A diverse, inclusive work environment that celebrates the unique perspectives and talents of all employees.
- A friendly company culture that encourages a healthy work-life balance.
Learn More and Apply
Learn more about TASB by visiting tasb.org or by following us on Facebook, Twitter, or LinkedIn. All job applications must be submitted online through our ADP application system. Only those candidates that closely meet the job’s requirements will be selected for interview and contacted.
- TASB is an equal opportunity employer and will not discriminate on the basis of an individual's race, color, disability, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, marital status, veteran status, or any other personal characteristic protected by law.
- This position does not qualify for visa sponsorship.
- This position is subject to a background check. Any job offer is contingent upon receipt of results of a satisfactory background check.