Clinical Review RN - 247797

Job Title : Clinical Review RN

Openings : 3

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

Background : Must have strong clinical background in maternal health, NICU, ICU, Emergency Med, or inpatient generalist. Must have strong writing skills.

Pay : $50-53 / hr

Location : the first 2 positions are remote but all 3 nurses must be local to NYC, Long Island or Westchester, NY. DO NOT apply if you live out of New York state.

Position Details :

They are looking for RNs with strong clinical backgrounds (more details below) who have very strong written communication skills. They will be reviewing the documentation, medical records, and more to provide written clinical summaries to boards of review or other governing bodies.

These nurses will all be a part of the same team and working between the Maternal Mortality Project & Office Based Surgical Incidents. If the nurse is also open to being a part of the School Based project, they would like that as well but not required.

DUTIES :

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

QUALIFICATIONS :

EDUCATION & EXPERIENCE :

Maternal Mortality Project (remote) :

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 (remote) :

The second project that they will be working on will be unexpected office based surgeries. These are faster turnarounds and they are reporting up to DOH. They will review the cases where unexpected surgeries had to happen in an office setting (can be across numerous outpatient settings).

School Based / Family Planning Clinics Reviews (field / remote) :

This program does audits of the school based maternal / child health programs and family planning clinics. They will be working with NYC schools in the 5 boroughs, Long Island, and Westchester. These audits will take multiple days and there will be a team that is allocated to review documentation submitted as well as chart reviews.

This role would need people who are open to going on ~25 onsite visits throughout the year. This will be reviewing the locations and where the care is taking place. They will be traveling onsite alone but would be relatively easy.