You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
JOB SUMMARY
Our client is seeking a Clinical Reviewer to play a crucial role in two significant projects. This position involves reviewing case records related to maternal deaths, evaluating clinical documentation, phone interviews, and other pertinent information for a federal database and state requirements. Additionally, the role includes reviewing cases of unexpected office-based surgical incidents, providing written clinical summaries to review boards or governing bodies. The reviewer will also perform comprehensive evaluations of primary, preventative, and reproductive healthcare provided within school-based health centers and family planning clinics, which includes on-site observations.
KEY RESPONSIBILITIES
- Complete all pre-review activities, including reviewing previous monitoring information and submitted program documentation.
- Conduct hybrid monitoring activities, including reviewing patient records and billing, for all required components and timeframes.
- Perform site observations and staff interviews, noting any deficiencies.
- Provide technical assistance to program personnel, where appropriate.
- Utilize data management tools to draft provider monitoring reports in accordance with monitoring findings.
- Track the status of documents and reviews in databases and other shared platforms.
QUALIFICATIONS
- Ability to work independently and as part of a team, capable of prioritizing reviews and projects.
- Strong analytical skills.
- Ability to gather and analyze information from records, reports, and other sources.
- Proficiency in standard office technology and basic Microsoft applications including Word, Excel, and Teams.
EXPERIENCE
- A minimum of two years of clinical practice experience in pediatric/adolescent/reproductive health care, preferred.
- A minimum of two (2) years of experience reviewing charts for the purpose of quality improvement or utilization review, preferred.
- Strong clinical background in maternal health, NICU, ICU, Emergency Medicine, or as an inpatient generalist.
SKILLS
- Strong written and verbal communication skills.
- Ability to focus on facts and maintain objectivity in sensitive cases.
- Proficiency in Microsoft applications including Word, Excel, and Teams.
EDUCATION
- Qualified and actively credentialed/registered in New York State (e.g., Registered Professional Nurse, Pediatric/Family Nurse Practitioner, Physician’s Assistant).
- A bachelor’s degree in nursing OR graduate of an approved Registered Professional Nurses training program, required.
ADDITIONAL REQUIREMENTS
- Ability to travel for on-site review assignments within the metropolitan area (including Westchester and Long Island), approximately 25 on-site days per year.
- A three-month training period will be provided, including significant one-on-one instruction and team meetings to ensure successful integration.
- Interviews will include at least one round with the hiring manager, followed by a writing sample requirement for candidates without a strong writing background.
- This is a 40-hour per week position, with hours typically between 7:00 AM and 5:30 PM, Monday through Friday.
- Commitment to reviewing cases objectively, focusing on facts rather than emotions.
Start Date
ASAP
Length of Assignment
52 weeks
Hours Per Week
40
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
