Nurse Practitioner Advisor

University of Massachusetts Medical School; Westborough (MA); On-site; USD 110,000 - 140,000; Full time

Job summary

University of Massachusetts Medical School is seeking an Advisor to review medical records, construct functional capacity reports, and decide on disability for applicants seeking benefits. The role provides clinical guidance to staff and ensures sign-off from a physician when needed.

The Advisor oversees report quality, participates in quality initiatives, and collaborates with clinical leadership to interpret regulations and develop clinical policies.

Qualifications

• Master’s degree in Nursing (MSN) or Doctor of Nursing Practice (DNP).
• Nurse Practitioner board certification.
• 3–5 years of direct patient care experience.
• Experience with MassHealth or Medicaid.
• Proficiency in Office Applications.

Responsibilities

• Determine whether an individual applying for benefits meets clinical and functional criteria.
• Review medical records, approve or deny staff recommendations.
• Advise clinical personnel on case development and functional capability.
• Contribute to quality improvement initiatives.
• Participate in quality team case reviews.
• Collaborate with clinical leadership on policies and training.

Skills

Office Applications

Clinical guidance

Disability evaluation

Education

MSN or DNP

Tools

MassHealth/Medicaid familiarity

Job description

Overview

POSITION SUMMARY:

The 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.

Responsibilities

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.

Qualifications

REQUIRED QUALIFICATIONS:

• Master’s 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