Address
Form of workSalary : $84,744.00 - $138,852.00 Annually
Location : Thurston County - Tumwater, WA
Job Type: Full Time - Permanent
Remote Employment: Flexible/Hybrid
Job Number: 2023-15960
Department: Dept. of Labor & Industries
Division: Insurance Services - Office of the Medical Director
Opening Date: 12/21/2023
Closing Date: 1/10/2024 11:59 PM Pacific
Description
Our Mission: Keep Washington Safe and Working!Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability
Are you a professional nurse that would like to make a difference with the Department of Labor and Industries? Do you have a passion to help injured workers get the services and help they need?
The Office of the Medical Director is seeking a professional, clinical consultant to work on the utilization review team to ensure timely processing of requests for inpatient/outpatient surgery, inpatient hospitalizations and other procedures that require UR.
You would support the Department of Labor and Industries goal to help injured workers heal and return to work by:
Duties
Some of what you'll do:
Qualifications
Required:
The top candidate must have proficient written and verbal communication skills, and be able to work independently with limited direct supervision.
Desired:
Supplemental Information
Things You Need To Know
To help you maintain a proper work-life balance, teleworking is one of the work schedule options for this position. L&I also offers flexible custom work schedules.
State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee's career. Click on the "Benefits" tab to learn more.
At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.3 million workers. Take a look at this and learn more about why L&I is an employer of choice.
Telework is dependent upon business needs and supervisor approval. For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer.
The assigned duty station for this position is Tumwater, Washington.
Application process
We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement.
Please include the following documents with your application:
Other information
Washington is to live, play, and work, according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.
In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers.
Veterans Preference
Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers. For further information, contact L&I's Diversity, Equity, and Inclusion EmployerL&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency's greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.
The State of Washington is an equal opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360-902-5700. TTY users should first call 711 to access the Washington Relay Service.
You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.For more InformationIf you have any questions regarding this job posting, program, or the agency, please contact the
More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
The Washington State Employee Assistance Program promotes the health and well-being of employees.
Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.
Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.
Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.
Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.
Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.
Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.
Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.
Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.
Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.
Pay status includes hours worked, time on paid leave and paid holiday.
As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.
Note: Most agencies follow the civil servi...
Location : Thurston County - Tumwater, WA
Job Type: Full Time - Permanent
Remote Employment: Flexible/Hybrid
Job Number: 2023-15960
Department: Dept. of Labor & Industries
Division: Insurance Services - Office of the Medical Director
Opening Date: 12/21/2023
Closing Date: 1/10/2024 11:59 PM Pacific
Description
Our Mission: Keep Washington Safe and Working!Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability
Are you a professional nurse that would like to make a difference with the Department of Labor and Industries? Do you have a passion to help injured workers get the services and help they need?
The Office of the Medical Director is seeking a professional, clinical consultant to work on the utilization review team to ensure timely processing of requests for inpatient/outpatient surgery, inpatient hospitalizations and other procedures that require UR.
You would support the Department of Labor and Industries goal to help injured workers heal and return to work by:
- Reducing delays and expediting medical services for injured workers.
- Building and maintaining partnerships with internal and external stakeholders.
- Participating in regular review of clinical recommendations from the UR vendor.
- Joining continuous quality improvement (CQI) efforts with UR team.
Duties
Some of what you'll do:
- Act as clinical liaison for Utilization Review (UR) review inquiries.
- Respond to inquiries and resolves issues related to clinical requests submitted to the L&I utilization review vendor.
- Address barriers to ensure timely clinical recommendations from the UR vendor
- Use clinical expertise to research claim file in ORION.
- Build and maintain partnerships with key stakeholders, including medical providers, attorneys, claim managers and injured workers.
- Provide clinical education and support for the adjudication staff in claims.
- Perform UR review and quality assurance daily.
- Program analysis.
- And much more!
Qualifications
Required:
- Must have a valid and current RN license
- Must obtain a valid WA state RN license prior to date of hire.
- Bachelor of Science in Nursing (BSN) and five years of acute care clinical nursing experience or nursing experience with worker's compensation insurance.
The top candidate must have proficient written and verbal communication skills, and be able to work independently with limited direct supervision.
Desired:
- Two or more years of experience in utilization review, case management, or quality assurance.
- Experience with problem solving in complex situations involving multiple parties with diverse needs and interests.
Supplemental Information
Things You Need To Know
To help you maintain a proper work-life balance, teleworking is one of the work schedule options for this position. L&I also offers flexible custom work schedules.
State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee's career. Click on the "Benefits" tab to learn more.
At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.3 million workers. Take a look at this and learn more about why L&I is an employer of choice.
Telework is dependent upon business needs and supervisor approval. For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer.
The assigned duty station for this position is Tumwater, Washington.
Application process
We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement.
Please include the following documents with your application:
- A describing specific qualifications.
- A current detailing applicable experience and education.
- A list of at least three professional references with current telephone numbers.
Other information
- A job offer is contingent upon completion of a background check that includes a criminal record review.
- For positions requiring travel, you must have a valid unrestricted driver's license and have insurance if driving a privately owned vehicle on state business.
- This position is represented bytheWashington Federation of State Employees (WFSE).
- Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.
- The Department of Labor & Industries complies with the employment eligibility verification requirements of the federal employment eligibility verification form, I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment.
Washington is to live, play, and work, according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.
In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers.
Veterans Preference
Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers. For further information, contact L&I's Diversity, Equity, and Inclusion EmployerL&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency's greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.
The State of Washington is an equal opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360-902-5700. TTY users should first call 711 to access the Washington Relay Service.
You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.For more InformationIf you have any questions regarding this job posting, program, or the agency, please contact the
More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
The Washington State Employee Assistance Program promotes the health and well-being of employees.
Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.
Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.
Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.
Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.
Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.
Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.
Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.
Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.
Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.
Pay status includes hours worked, time on paid leave and paid holiday.
As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.
Note: Most agencies follow the civil servi...
