Full-time Nurse Practitioner Clinical Reviewer

Position Summary

The Nurse Practitioner Clinical Reviewer will be responsible for reviewing Remote Patient Monitoring (RPM), Behavioral Health (BHI), and Chronic Care Management (CCM) reports, assuring the integrity and appropriateness of reporting elements.

It is the hope that these reports will assist the facilities in the care of their residents/patients and caregivers.

The Nurse Practitioner will also be responsible for any escalation of alerts that come through the Passive Device Alert Center (PDAC) that is identified as needing immediate review and notification of facility. The alerts are of high risk to the resident. Each Nurse Practitioner will be rotated to cover the PDAC center.

*Must hold at least 5 active NP licenses*

PRIMARY RESPONSIBILITIES:

Complies with documentation requirements of the care management services as defined by Tapestry Care Management department

Responsible for contacting facilities clinical leadership team or designee and/or facility Tapestry clinician for the purpose of obtaining feedback on reports supplied and review the patient specific clinical reports.

Contact with the facilities may be by phone, video conference, in person or through sharing written reports. One on one meetings with designated facility representative will also be set up if the facility clinical representative request using video conferences platform to educate and review utilization of reports and benefits of these reports. Questions will be answered to the facility via email, phone, or the video conference meeting arranged

A phone log of the facilities receiving RPM and CCM reports will be maintained on name of facility, person who spoke with at facility, date, time whether by email or phone. Protocol for follow up with facilities will be followed as outlined in workflow process.

When notified of an escalated alert from the clinicians in the PDAC reviews the alert and analyze and notifies facility contact of it.

Adheres to the established policy/protocol established for the Alerts for the (PDAC)

Ensures the notification of the appropriate facility provider of the high red alert and discuss findings

Ensures uses Zoom/and or designated platform for purpose of documenting time spent and any actions taken with alert process.

Work with care management team members to collaborate and improve workflow process

Communicate with Clinical Director of care management on issues regarding quality, system capacity, and resource requirements, facility and/ or provider feedback.

Strive to meet established standards for productivity.

Develops relationships across facilities organization and within Tapestry Health to facilitate communication and improvement of program.

Updates all Care Management team members if any contacts have changed within a facility

Meets with the Director of Care Management on regular basis monthly

Performs all duties and responsibilities and adheres to the Nurse Practice Act.

Works with consultants in resolving mismatch patient information, any discrepancies within the reports (i. e., Date of service, Dates of birth, completeness of report etc), and obtaining reports through Smartsheet

Ensures Timelines Are Met

Protects patient information and adheres to standard of confidentiality with all patient information

Contributes and participates in any performance improvement and continuous quality improvement activities within the Care Management Work realm.

All other duties as assigned.

Minimum Requirements

Advanced Practice Nurse practitioner education and certification.

Licensed NP in at least 5 states.

Knowledge and Skill in chronic disease and remote patient monitoring management

Proficient with Adobe, Microsoft Word, Excel, and video conferencing platforms and Dashboard type platforms.

Monday-Friday, standard business hours.

Preferred Skills

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.

The anticipated annualized salary for this role is $115K-125K. This remote position follows a location-based compensation structure. The posted salary range represents the potential pay range across various U.S. geographic markets. Actual compensation will be determined based on the candidate’s primary work location, experience, qualifications, and internal equity considerations, in accordance with applicable pay transparency laws.