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RN Educator - REMOTE in Tampa, FL at KEPRO

Date Posted: 2/2/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Tampa, FL
  • Job Type:
    Nurse
  • Experience:
    Not Specified
  • Date Posted:
    2/2/2018

Job Description

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 1 billion people receive the right care, at the right time, in the right setting. KEPRO is recruiting for the following excellent career opportunity in our Tampa, FL location:

RN Educator - Healthcare

Responsible for the required provider education associated with CMS' claims redetermination reviews.

  • Produce the written Final Review Result correspondence; to include:  Individualized hospital results; claim-by-claim rationales; clinical details that can be used to foster further discussions and serve as basis for provider educational sessions
  • Facilitate one-on-one provider educational sessions
  • Maintaining all timelines associated with claim determination reviews
  • Providing monthly summaries/updates for the CMS report
  • Meeting contract evaluation measures; meeting all contract timeframes for reviews
  • Maintaining lines of communication (verbal/written) between the BFCC QIO, healthcare providers and/or practitioners
  • Cross train and perform duties of other contracts with KEPRO to provide a flexible workforce to meet goals/objectives

QUALIFICATIONS

  • Unrestricted, active RN license, required
  • BSN and CPUR, preferred.
  • 5 years’ clinical experience in either a short-term acute care hospital or skilled nursing facility, required
  • 5 years’ previous experience as a claims or risk manager, preferred
  • Previous experience reviewing/investigating patient complaints and QI required
  • Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail w/analytical skills and demonstrated ability in decision-making
  • Demonstrated initiative and judgment in performance of job responsibilities, while maintaining professionalism, flexibility and dependability under pressure
  • Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including  building and maintaining relationships with internal/external customers and facilitating meetings
  • Ability to work independently and as part of a team
  • Interest in continuous learning and a commitment to staying informed on regulatory changes

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  Come grow with a progressive health care management leader. Only those candidates identified for an interview will be contacted.  No phone calls, please.  Visit us 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.

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