Nurse Practitioner Advisor

ForHealth Consulting at UMass Chan Medical School; United States; On-site; USD 90,000 - 130,000; Full time

Job summary

ForHealth Consulting at UMass Chan Medical School seeks an Advisor to review medical records, construct functional capacity reports, and decide disability for applicants seeking benefits. The role requires clinical judgment and adherence to federal and state criteria, with physician sign-off when necessary.

The Advisor provides clinical guidance to staff, oversees the quality of reports, and leads quality improvement initiatives, ensuring documentation meets standards and participates in

Qualifications

• Must hold MSN or DNP in Nursing.
• NP board certification required.
• 3–5 years of direct patient care experience.

Responsibilities

• Determine disability status based on clinical criteria and law.
• Review medical records and approve/deny recommendations.
• Advise clinical staff on case development and functional capability.
• Contribute to quality improvement initiatives.
• Participate in quality team case reviews.
• Collaborate with leadership to develop policies and training.

Education

MSN or DNP

Tools

Office Applications

Job description

Position Summary

Advisor is responsible for reviewing medical records, constructing functional capacity reports and deciding of disability for applicants seeking benefits based on disability. Advisors provide clinical guidance to staff. Advisors oversee the quality of reports and documentation produced by their peers and determine quality improvement initiatives as appropriate. Advisors shall obtain sign-off from a physician on decisions; when necessary.

Major Responsibilities

• Responsible for determining whether an individual applying for benefits as a result of disability meets specific clinical and functional criteria established by federal and state law and regulation.
• Review medical records, approves, or denies recommendations made by staff regarding the disability status of an applicant.
• Advises clinical personnel regarding case development and determines the functional capability of an applicant based upon a comprehensive review of all records.
• Contributes to quality improvement initiatives.
• Participate in quality team case reviews.
• Collaborate with clinical leadership in the interpretation of regulations, development of clinical policies and quality evaluations, provide feedback to peers and other staff regarding clinical policies and the outcomes of quality evaluations, and assist in the development and training.

Required Qualifications

• Masters Level Degree of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
• Nurse Practitioner Board Certified
• 3-5 years of experience in direct patient care.

Preferred Qualifications

• Experience with MassHealth or Medicaid
• Proficiency in Office Applications

The University of Massachusetts Chan Medical School welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.