Trabajos utilization review nurse en Durham, North CarolinaCrear alertas

Job Description Job Summary: RMMs will report to the CMO who will collaborate with the COO for assignments related to this role. Regional Medical Managers (RMMs) will be assigned to Regional Director of Operation regions (East, Central, West) and will work with RDOs and CMs in their assigned region on back-office performance improvement initiatives to drive positive change within each center assigned focusing on quality of care and patient volumes. RMM’s will ownership in the success of each center they are assigned to improve in partnership with the RDOs and CMs. RMM role will have 12 hrs. /week of dedicated administrative time; and a minimum 24 hours/week covering clinic shifts. RMMs will be compensated at $85/hr and will remain OT eligible for any additional clinical hours worked when needed. Incentive compensation will be included for the success of their sub-region clinic performance and will align with RDO goals. Weekly regional travel to centers in their assigned territory will be required. Mileage and lodging reimbursement as per company policy will be honored. Will often work 1:1 with providers and back-office staff in need of assistance. Job Duties: • RMMs will meet with the CMO and COO monthly and MAB as needed to identify and report on any operational or clinical challenges and prioritize specific action plans for the RMMs to focus on in the field with operational partners., • Applicants must exemplify our Mission, Vision and Values, understand and believe in our lean business model of healthcare delivery, and promote our ability to provide exceptional patient care, access and experience in the communities we serve., • RMMs are solely focused on quality improvement, center growth, and back-office support., • RMMs will collaborate with lead operators of their assigned region to ensure clinical, operational and financial success., • Assist any APPs/staff struggling with patient thruput with emphasis on quality, process improvement and efficiencies., • Work directly with CMs, APPs and back-office staff to improve center performance and quality of care delivered., • RMMs will provide a monthly report documenting their specific activities, accomplishments, challenges, and any recommendations to correct challenges identified., • Assist with accurate, yet efficient, documentation completion that ensures records are documented accurately without compromising patient thruput, so we maintain the ability to improve patients per hour if possible. Ensure chart completion within 24 hours of DOS., • Improve confidence and practice with any provider procedures deemed deficient. Assist with resolving any core privileging deficiencies. Assist in noncompliance with completion of any assigned HIPPO education modules., • Work with providers who struggle with bedside manners, teamwork, tardiness, or absenteeism., • Assist with In-basket management compliance including coding queries, chart completion, lab result review, radiology over-read review, and patient inquiries., • Accuracy of DOT exam documentation, quality of OHS documentation, appropriateness of follow-up and OHS referrals. Increase in E-screen utilization, completion DOT certification and OHS workshop within 90 days of hire. Compliance with DOT recertification., • If applicable, encouraging appropriate referrals from urgent care to primary care and facilitating that process. A Primary Care RMM will work with Primary Care providers to improve management of outside events, transitional care, in basket management, outside document management, increasing patient panel size, increasing annual physical visits, timely medication refills, and assistance with remedial training of primary-care procedures., • Google scores, volumes, access (no window triage), schedule utilization (walk-ins encouraged), AV efficiency, callouts, etc. Qualifications: • Certified Nurse Practitioner/Physician Assistant, • Must be full-time; minimum one-year1 year with Fast Med and a minimum of 2 years clinical experience., • Prior experience as a clinician educator experience or Lead APP preferred., • Excellent written and verbal communication skills; must be able to lean into difficult conversations to drive change and process improvement., • Prior experience establishing strong working relationships.