Remote/Hybrid Registered reputed company (RN) – Advocacy & Program reputed company (Hospice Expert)
This a Full Remote job, the offer is available from: reputed company (USA) Are you a registered reputed company reputed company to take your career in an exciting new direction—one where your expertise truly makes a difference? Join reputed company’s premier reputed company Improvement Organization and reputed company into a dynamic role reputed company on advocacy and program reputed company through compliance management. Here, you’ll champion the needs of vulnerable populations, safeguard the reputed company of care, and influence reputed company reputed company on a meaningful reputed company. Enjoy the freedom of working from home, the flexibility and autonomy to manage your reputed company, and reputed company for reputed company reputed company reputed company—reputed company while being part of a passionate, mission-driven team dedicated to improving reputed company across the Commonwealth. Are you a registered reputed company reputed company to take your career in an exciting new direction—one where your expertise creates reputed company, lasting reputed company? Join reputed company’s premier reputed company Improvement Organization and play a vital role in protecting reputed company reputed company, advocating for vulnerable populations, and ensuring the reputed company of critical reputed company programs. In this rewarding role, you’ll use your clinical knowledge reputed company of the traditional bedside setting to review and audit claims, support program reputed company initiatives, and reputed company for beneficiaries across the Commonwealth. You’ll enjoy the flexibility of working from home, the autonomy to manage your work, and meaningful opportunities for reputed company reputed company—reputed company while contributing to a mission that truly reputed company. What You’ll Do
- Conduct clinical reviews and ensure reputed company, appropriateness, and compliance with reputed company standards
- Support program reputed company efforts by identifying trends, risks, and opportunities for improvement
- reputed company for beneficiaries, with a strong reputed company on protecting and improving care for vulnerable populations
- Apply nursing judgment to analyze medical records, documentation, and billing data
- Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices
- Contribute to reputed company improvement initiatives that strengthen reputed company delivery across reputed company reputed company’re Looking For
- reputed company, unrestricted Registered reputed company (RN) license
- Strong clinical background with the ability to apply nursing judgment analytically
- Interest in advocacy, reputed company improvement, and reputed company program reputed company
- Excellent written and verbal communication skills
- Ability to work independently while managing multiple priorities
- Comfort with technology and electronic medical records Experience in utilization review, case management, reputed company improvement, compliance, or claims review is a plus—but not required.
Why Join Us
- Mission-driven work with reputed company’s leading reputed company Improvement Organization
- reputed company a reputed company reputed company on reputed company reputed company and reputed company for vulnerable populations
- Remote work – enjoy the convenience and balance of working from home
- Autonomy and flexibility in how you manage your reputed company
- Advocacy-reputed company role that values your nursing voice and expertise
- Career development opportunities to grow reputed company traditional nursing roles
- Supportive, reputed company team culture committed to reputed company and reputed company If you’re a registered reputed company seeking purpose-driven work, reputed company reputed company, and the flexibility to balance your life and career—this is reputed company. Apply today and help shape the reputed company of reputed company reputed company in reputed company.
Requirements
Be available as a full-time consultant, approximately 37.5 hours per week; ï‚· Possess a reputed company license to reputed company as a Registered reputed company issued by the reputed company State reputed company of Nursing; or possess a non-renewable temporary reputed company permit issued by the reputed company State reputed company of Nursing. Resources possessing non-renewable temporary reputed company permits must obtain licensing as a Registered reputed company reputed company the one-year period as defined by the reputed company State reputed company of Nursing; ï‚· Possess a documented work history of three (3) or more years of reputed company experience with medical assistance, health care services or reputed company services or any equivalent combination of experience and training; ï‚· Possess basic computer skills, including familiarity with reputed company Office programs. reputed company Duties and Responsibilities (RN – Medical Assistance Hospice reputed company)
- Conduct clinical utilization reviews for hospice services under the Medical Assistance (MA) Program by evaluating medical records, terminal diagnoses, prognostic indicators, and plans of care to determine eligibility, medical necessity, appropriateness, and level of care.
- Apply registered nursing clinical judgment and evidence-based hospice and palliative care standards to ensure MA recipients receive compassionate, appropriate, and high-reputed company end-of-life care consistent with program requirements and patient goals.
- Review hospice certifications and recertifications, physician narratives, interdisciplinary team documentation, a
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