Program Review Associate – RN

TITLE:  Program Review Associate – RN

JOB DETAILS:

Horizon Healthcare Staffing is searching for Registered Nurses for a temporary 6 month assignment in Nassau County, NY. This RN job does not require travel; it is an in-house position.

• We require at least 2 years of experience
• This position starts ASAP
• Monday-Friday 8:30am – 5:00pm

GENERAL RESPONSIBILITIES:

The Registered Nurse performs hospital utilization and quality reviews and must have the ability to work independently with little supervision. Effective written and oral communication skills with physicians, administrative and medical personnel. Understands and uses required peer review monitoring tools.

DUTIES:

• Review medical records for medical necessity, appropriateness, quality of care and DRG validation.
• Complete worksheets and required review screens as well as refer questioned cases to physician reviewers.
• Make appropriate recommendations as a result of monitoring activities.
• Provide technical assistance to personnel where appropriate.
• Prepare reports on performance utilizing appropriate monitoring tools.
• Assist in analyzing data to identify problem areas for further review.
• When assigned, provide staff-support to appropriate committees and/or accept additional assignments as per request of Supervisors.
• Conduct special projects.
• Consistently implement ISO regulations and standards by following policies, procedures and work instructions.
• Maintain consistent emphasis on customer satisfaction both internal and external to maintain a working quality system and continual improvement.

QUALIFICATIONS:

• Licensed as a Registered Professional Nurse in New York State.
• Ability to work independently with minimal supervision.
• Ability to relate effectively with medical and administrative personnel as well as the "public".
• Excellent written and verbal skills.

EDUCATION & EXPERIENCE:

• Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York.
• A minimum of 2 years experience in an acute care facility preferably in medicine/surgery or special care units and/or 2 years experience in acute utilization review.