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Clinical Reviewer, Registered Nurse Remote in the state of LA

Company: Kepro
Location: Saint Louis
Posted on: January 15, 2022

Job Description:

Description

Clinical Reviewer
Are you a licensed clinician looking for a new challenge?
Are you motivated, energetic, and excited to become part of the Kepro team?

If so, you might be our next new team member!

Note: This is a remote position, where you will have the ability to work a flexible schedule. You must be licensed in LA. Residency in LA is preferred.

Hours: This can be a full-time (with benefits), part-time (with or without benefits), or PRN (with 401K option) role, based on your scheduling preferences.

Who We Need

Your clinical reviews will help individuals with mental illness, intellectual disability, or related conditions receive referrals for a full evaluation to assess for services that they may need to be successful in nursing homes. In this very meaningful role, you will conduct clinical reviews for individuals with mental illness and/or intellectual disability who may be eligible for additional services in nursing homes. This is a great opportunity for you to enhance your clinical expertise by learning from our experienced staff, while improving lives.

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What You'll Do
Reviews and interprets patient records and compares against criteria to determine if a comprehensive evaluation is required.
Abstracts review related data/information accurately and timely on appropriate review tool by the appropriate means. Accurate and timely submission of all administrative and review related documents to appropriate parties.
Performs ongoing reassessment of review process to offer opportunities for improvement and/or change.
Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process.
Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
Always maintains medical records confidentiality through proper use of computer passwords, maintenance of secured files, adherence to HIPAA polices.
Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Kepro policies, procedures, and guidelines
Actively cross-trains to perform duties of other contracts within the KEPRO network to provide a flexible workforce to meet client/consumer needs.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications
Active license in good standing in the State of Louisiana in a mental health profession or hold an RN license in Louisiana and have at least one year's experience in adult psychiatric and mental health practices.
Graduation from an accredited College with relevant Degree Program.

Knowledge, Skills, Abilities
Medical record abstracting skills required.
Knowledge of the organization of medical records, medical terminology, and disease process required.
Strong clinical assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to work in a team environment.
Flexibility and strong organizational skills needed.
Must be proficient in Microsoft Office and internet/web navigation.

Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!

- The Kepro Talent Acquisition Team

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.Kepro.com for more information on the Kepro Family of Companies.

EOE AA M/F/Vet/Disability

Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Summary Description

PASRR Evaluators complete face-to-face, clinical assessments of individuals with mental illness and/or intellectual disability. Assessments typically occur in nursing homes or hospital settings. Evaluators assess level of care needs and provide determinations and recommendations for ongoing care. Assessments are completed with the use of our electronic system which supports the creation of all determinations and notifications for distribution to the applicable parties.

Accountabilities
Knowledge of Federal Regulation 42 CFR, Chapter 483.
Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in Nebraska.
Knowledge of standards of practice related to determination of Level of Care.
Knowledge of standards of practice related to mental health, intellectual and developmental disabilities, geriatrics, and other disorders typically requiring long term care services and supports.
Knowledge and understanding of public sector services and supports.
Computer proficiency in Microsoft Excel, Word and Outlook.
Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
Ability to utilize computer equipment and web based software to conduct work.
Ability to interact with various office staff as needed to support necessary workflows.
Ability to interact with healthcare professionals, patients, their families and other supports.
Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
Assesses and analyzes psychological, emotional, behavioral and physical functioning.
Develops level of care recommendations based upon clinical evaluations.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications
Active unrestricted licensure in Nebraska in healthcare or related field, such as RN, LMHP, LIMHP, CMSW, LCSW, CSW, or Psychologist.
Graduation from an accredited Diploma, Associates Degree or Bachelor's Degree Program, Masters preferred.

Knowledge, Skills, Abilities
Medical record abstracting skills required.
Knowledge of the organization of medical records, medical terminology, and disease process required.
Strong clinical assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to work in a team environment.
Flexibility and strong organizational skills needed.
Must be proficient in Microsoft Office and internet/web navigation.

Experience
Minimum of 3 years' experience in the assessment and/or diagnosis of individuals with mental/psychiatric disorders, including complex differential diagnoses that are related to substance use, medical conditions, cognitive issues, and dementia.
Experience with geriatric population is preferred.
Minimum of (1) year of experience in working with individuals with intellectual disability or related conditions.

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.

EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

Keywords: Kepro, St. Louis , Clinical Reviewer, Registered Nurse Remote in the state of LA, Healthcare , Saint Louis, Missouri

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