Program Review Associate – Registered Nurse (RN) /Licensed Professional Nurse (LPN)
This individual will complete the full spectrum of activities related to Medical Record chart abstraction as it relates to reviews for Cost Outliers, and medical record abstraction for clinical special projects, including abstraction for HIV positive pregnant women and sexually transmitted diseases, a review for Pre exposure prophylaxis (PrEP) in high risk populations, and an HIV/aging cohort review.
- Work to abstract data from clinical records for different review categories such as cost outlier review, which requires a bill check to review for supporting documentation that will allow billed services to be paid. For this review type, interaction with coders, who will be validating the paid DRG on the case can be required.
- Reviews can also be for clinical review data collection for an HIV review program. These clinical reviews include one to collect data on HIV positive pregnant women and sexually transmitted diseases, or one to determine if patients at risk for HIV are receiving Pre-Exposure Prophylaxis (PreP).
- Reviews may be required for an HIV aging cohort of both HIV positive and negative patients to compare clinical
- All data will be abstracted from electronic health records (EHRs) and entered into an electronic fillable worksheet for any
- Other activities or projects as they may be
Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York.
New graduates can be considered though some degree of clinical experience and use of EHRs is
Knowledge and experience with electronic hart review and DRGs
Licensed as an RN in New York State.
Licensed as an LPNs with two years of medical/surgical hospital experience