Clinical Review RN - 247797

Remote Full-time
Job Title: Clinical Review RN Openings: 2 Hours: 40 hours a week between 7:30am-5:30pm Background: Must have strong clinical background in maternal health, NICU, OBGYN, L&D, Pediatrics. Must have strong writing skills. Pay: $50-53/hr Location: Remote, but must be local to New York. 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: • The ability to work independently, as well as in a team environment, and to prioritize reviews and projects to be completed. • Strong analytical and communication skills (both written and verbal). • Ability to gather and analyze information from records, reports, and other sources. • Proficient in the use of standard office technology and basic Microsoft applications including Word, Excel, and Teams. EDUCATION & EXPERIENCE: • Qualified, and actively credentialed/registered in New York State • A minimum of two (2) years of clinical practice experience in pediatric/adolescent/reproductive health care. • A minimum of two (2) years of experience reviewing charts for the purpose of quality improvement or utilization review. 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). Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Experienced Utilization Reviews Appeals Registered Nurse – Remote Work from Home Opportunity in Managed Care Setting

Remote Full-time

Health Informatics Analyst

Remote Full-time

Experienced Customer Service Representative – Part-Time Remote Position with Google Cloud

Remote Full-time

K-Beauty Social Media Marketing Full-Time

Remote Full-time

Lead/Senior Quantitative Analyst, Predictive Modeling

Remote Full-time

Interior Design Administrative Assistant

Remote Full-time

Executive Director, Market Impact (Remote in South Florida)

Remote Full-time

Entry Level Environmental Scientist

Remote Full-time

eDiscovery Litigation Specialist

Remote Full-time

Senior Director of AI, R&D & Agentic Systems

Remote Full-time
← Back to Home