Offer summary

Qualifications:

Master’s Level Degree of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) required., Nurse Practitioner Board Certified is essential., 3-5 years of experience in direct patient care is necessary., Experience with MassHealth or Medicaid is preferred. .

Key responsabilities:

Review medical records to determine disability eligibility based on established criteria.

Approve or deny recommendations regarding applicants' disability status made by staff.

Advise clinical personnel on case development and assess applicants' functional capabilities.

Participate in quality improvement initiatives and collaborate with clinical leadership on policy development.

Massachusetts’ first and only public academic health sciences center is made up of three graduate schools and two business divisions, ForHealth Consulting at UMass Chan Medical School and MassBiologics. Perennially ranked among the top medical schools for primary care education by U.S. News & World Report, UMass Chan Medical School is also an international leader in biomedical research, with $399 million in NIH funding in FY 2020. UMass Chan educates physicians, scientists and advanced practice nurses to heal, discover, teach and care with compassion. Our researchers are making discoveries daily in the fight against diseases such as ALS, Tay-Sachs, COVID-19, cancer and diabetes. UMass Chan strives to advance the health and well-being of the people of the commonwealth and the world through pioneering education, research and health care delivery with clinical partner UMass Memorial Health. ForHealth Consulting at UMass Chan Medical School provides a wide range of care management and consulting services to government agencies, nonprofits and health care organizations, improving health care for people in need while also maximizing revenue for clients and performing cutting edge research that impacts health policy. MassBiologics, the only nonprofit, FDA-licensed manufacturer of vaccines and biologics in the United States, improves public health through applied research, development and production of biologic products, including vaccines, plasma derivatives and monoclonal antibodies.

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: