Clinical Review RN, Maternal Mortality - 253946

Job Title: Clinical Review RN (Maternal Mortality / Office Based Surgical Incidents)

Hours: 40 hours a week between 7:30am-5:30pm EST

Background: Must have strong clinical background in maternal health, NICU, OBGYN, L&D, Pediatrics, emergency medicine, inpatient. Must have strong writing skills.

Pay: $38.46-43.26/hr

Location: can sit in office in Albany or Jericho, NY

Position Details:

Looking for an RN with a strong clinical background (more details below) who has very strong written communication skills. Will be reviewing the documentation, medical records, and more to provide written clinical summaries to boards of review or other governing bodies.

The nurses will all be a part of the same team and will work between the Maternal Mortality Project & Office Based Surgical Incidents.

This individual will perform reviews of primary, preventative, and reproductive healthcare provided within school based health centers and family planning clinics, including conducting on-site observations of the clinics. The project requires an understanding and application of the associated regulations and guidelines, and use of standardized tools and databases.

DUTIES:

1. Completes all pre-review activities, including review of previous monitoring information, and review of program documentation submitted.
2. Completes hybrid monitoring activities, including review of patient records and billing, for all required components and time frames.
3. Conducts site observation and staff interviews, and notes any deficiencies.
4. Provides technical assistance to program personnel, where appropriate.
5. Completes data management tools to draft provider monitoring report in accordance with monitoring findings.
6. Tracks status of documents and reviews in databases and other shared platforms.

QUALIFICATIONS:

1. The ability to work independently, as well as in a team environment, and to prioritize reviews and projects to be completed.
2. Strong analytical and communication skills (both written and verbal).
3. Ability to gather and analyze information from records, reports, and other sources.
4. Proficient in the use of standard office technology and basic Microsoft applications including Word, Excel, and Teams.

EDUCATION & EXPERIENCE:

1. Qualified, and actively credentialed/registered in New York State
2. A minimum of two (2) years of clinical practice experience in pediatric/adolescent/reproductive health care.
3. A minimum of two (2) years of experience reviewing charts for the purpose of quality improvement or utilization review.

Maternal Mortality Project:

Reviewing case records where a maternal death occurred. This is tracked by CMS for a federal database and it is also required by NYS. When a case occurs, it will be evaluated by the review board. This candidate will be reviewing all of the clinical documentation, phone interviews (conducted by the staff) with loved ones, and all other pertinent information leading up to the death. They average about 50 cases a year and there is not a set turnaround time, but they would make sure that it is fully evaluated.

Office Based Surgical Incident Reviews:

These are faster turnarounds and are reporting up to DOH. Will review the cases where unexpected surgeries had to happen in an office setting (can be across numerous outpatient settings).