Job Description

We are seeking MSA Nurse Reviewers with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications. Candidates will demonstrate knowledge of CMS policies related to preparing MSAs. Strong writing skills, analysis skills and application of guidelines are required for this position. Our Analysts will work closely with our attorneys and other members of the medical team to prepare Medicare Set-Asides and Medical Cost Projections.

ABOUT THE DAY TO DAY RESPONSIBILITIES OF THE ROLE

• Through a review of relevant medical files and related documentation, provides a narrative and cost projection for future treatment related to Workers Compensation and Liability injuries consistent with the current guidelines
• Collaborates with a team of attorneys and medical professionals in identifying negotiating and documenting guidelines and cost reductions on future treatment plans
• Uses ISO Claims Partners proprietary information technology tools to identify diagnoses, treatment guidelines, and prescription medication pricing, and documents the case when applicable
• Provides additional analysis and medical recommendations as needed
• Identifies cost drivers and cost savings opportunities on all files and completes client specific -cost mitigation activities on files where applicable
• This is a full-time position, but additional hours may be required during peak time
• Occasional travel (<10% of the time)

Qualifications

• Bachelor’s Degree, Associate’s Degree or Diploma in Nursing
• Registered Nurse (RN) license required in good standing with the applicable Board of Nursing
• Experience preferred in preparing Medicare Set Asides and future cost projections
• Certification in any of the following preferred, including but not limited to Medicare Set-Aside Certified Consultant (MSCC), Life Care Planning (CLCP or CNLCP), Certified Case Manager (CCM), Rehabilitation Counseling, Disability Management, Utilization Review, Medical Coding, Legal Nurse Consulting 
• Strong interpersonal, oral, and written communication skills
• Ability to work effectively both independently and as a member of a team
• Ability to gather data, compile and synthesize information, including medical information, claims payment histories and billing, to identify level and types of services utilization

Additional Information

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

http://www.verisk.com/careers.html

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

CONSUMER PRIVACY NOTICE

AT VERISK, THE HEALTH AND SAFETY OF OUR PEOPLE IS OUR NUMBER ONE PRIORITY.  EFFECTIVE NOVEMBER 15, 2021, AND SUBJECT TO APPLICABLE LAW, ALL PROSPECTIVE HIRES FOR OFFICE BASED ROLES OR ROLES THAT SUPPORT ANY OF OUR BUSINESSES’ GOVERNMENT CONTRACTS WILL BE REQUIRED TO DEMONSTRATE THAT THEY ARE FULLY VACCINATED AGAINST COVID-19 BY THEIR START DATE, OR QUALIFY FOR A LEGALLY-REQUIRED MEDICAL OR RELIGIOUS ACCOMMODATION TO THIS VACCINATION REQUIREMENT, AS A CONDITION OF EMPLOYMENT. HIRED CANDIDATES WHO DO NOT DEMONSTRATE THAT THEY ARE FULLY VACCINATED AGAINST COVID-19 BY THEIR START DATE, AND WHO HAVE NOT BEEN APPROVED FOR A LEGALLY-REQUIRED MEDICAL OR RELIGIOUS ACCOMMODATION WILL NO LONGER MEET THE REQUIREMENTS FOR EMPLOYMENT AND THEIR OFFERS OF EMPLOYMENT WILL BE IMMEDIATELY RESCINDED, IN ACCORDANCE WITH APPLICABLE LAW.