Provider Education & Consultation Consultant - LPN, LVN, or RN
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Palmetto GBAHealthcare Administration
South Carolina, North Carolina, Georgia, and Alabama, 8:00 a.m.-5:00 p.m. Monday - FridayFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 7 years of clinical experience for LPN/LVN; 5 years of clinical experience for RN
- Required Skills
- Microsoft OfficeDocumentationAnalytical SkillsPresentation skills
Requirements
- Graduate of an accredited School of Licensed Practical Nursing (LPN), Vocational Nursing (LVN), or Nursing (RN).
- Minimum of 7 years of clinical/educator experience for LPN/LVN; minimum of 5 years for RN.
- Active LPN, LVN, or RN licensure in the state hired, or active compact multistate nursing license.
- Proficiency in Microsoft Office, including word processing and spreadsheets.
- Knowledge of medical terminology and disease processes.
- Strong presentation, organization, and analytical skills.
- Basic business math proficiency and understanding of statistical concepts.
- Ability to travel for in-person conferences and presentations.
- Ability to work occasional overtime as required by business needs.
Responsibilities
- Communicate and educate providers on Medicare coverage, utilization statistics, documentation, and medical review via advisories, reports, and telephone.
- Document all provider communications in the tracking system.
- Conduct formal conference calls and in-person educational visits for providers on corrective action or with high error rates.
- Deliver coverage and documentation workshops for provider staff.
- Research and coordinate regulatory-based provider education materials.
- Analyze reports to determine necessary actions regarding medical reviews and audits.
- Collaborate with the medical review department regarding provider billing practices.
- Participate in medical review processes and inter-reviewer reliability studies.
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