Nurse Practitioner Clinical Reviewer

POSITION SUMMARY:

This is a 1099 contractor position. We are seeking a Nurse Practitioner who can provide a minimum of 20 hours per week of consulting services. Work schedule is at your discretion and completely remote.

We require at least 5 state licenses at this time. Do not apply if you have less than 5 state licenses.

Please include all states in which you are licensed in as an NP, either in your CV or in a cover letter.

In this role, you will be responsible for reviewing pertinent patient data, developing care plans, recommending modifications to current treatments, tracking progress to goals, and signing off on the treatment plans once the review is completed. The output of your reviews will be used by onsite or telehealth providers to activate care plans and identify patients at risk for declining health status. Specifically, you will review records to enable Remote Patient Monitoring services (RPM), Behavioral Health (BHI), and Chronic Care Management (CCM) services.

PRIMARY RESPONSIBILITIES

• Review all curated patient data reports received for accuracy of clinical and demographic information; Review output of clinical care algorithms for accuracy and appropriateness in the context of each patients' medical history, care plan goals, and medications.
• Based on patient medical history and health status, develop care plans for the treating providers to implement
• Review progress to care plans; identify patients at risk for a decline in health without greater adherence to care plans
• Support Data Quality Reviewers, LPN Reviewers and RN Reviewers in building their clinical knowledge and clinical decision making to enhance the quality of the initial reviews
• Coach APP new hires to help them in building their understanding of the role, tools, and technology
• As needed, support initial clinical and demographic data review generated by the system to prepare and finalize final care plan sign off and billing.
• Identify discrepancies in data and/or algorithm output; escalate through defined channels for correction.
• Identify potential gaps in care to complete the review.

• Communicate with Director of Clinical Review on issues regarding quality, system capacity, and resource requirements, facility and/ or provider feedback.
• Meet established standards for productivity, quality, timeliness, and customer satisfaction
• Performs all duties and responsibilities and adheres to the Nurse Practice Act.
• Protects patient information and adheres to standard of confidentiality with all patient information
• All other duties as assigned.

MINIMUM REQUIREMENTS

• Advanced Practice Nurse Practitioner (Adult or Family) education and certification.
• Licensed as an Nurse Practitioner in at least 5 states
• Active and non-restricted license
• Knowledge and Skill in chronic care management and remote patient monitoring management preferred.
• Proficient with Adobe, Microsoft Word, Excel, and video conferencing platforms and Dashboard type platforms.
• Strong verbal/written communication and presentation skills
• Experience in working with team members to promote ideas, issues, and initiatives within a constructive group framework
• Must always represent the organization in a positive and professional manner
• Ability to organize and prioritize tasks
• Ability to work independently, be attentive to detail and maintain a positive attitude.

We kindly request that candidates refrain from contacting the company or HR directly regarding the status of their application. Our team will reach out to qualified candidates directly should there be a fit for the position. We appreciate your interest!

Pay Range: $60 per hour