Nurse Practitioner Clinical Reviewer-FTE

TapestryHealth, based in Connecticut, is the leader in providing Chronic Care Management, Remote Patient Monitoring, and Primary Care services for Long Term Care and Post Acute facilities. The company leverages a suite of technology to create a 24/7 safety net around each resident, enabling proactive care.

This is a full-time role at 40 hours per week, standard business hours. Please include all states in which you are licensed in as an NP, either in your CV or in a cover letter. We require at least 10 state licenses. In this role, you will be responsible for reviewing pertinent patient data, developing care plans, recommending modifications to current treatments, tracking progress to goals, and signing off on the treatment plans once the review is completed. The output of your reviews will be used by onsite or telehealth providers to activate care plans and identify patients at risk for declining health status. Specifically, you will review records to enable Remote Patient Monitoring services (RPM) and Chronic Care Management (CCM) services.

Review all curated patient data reports received for accuracy of clinical and demographic information; Review output of clinical care algorithms for accuracy and appropriateness in the context of each patients’ medical history, care plan goals, and medications. Based on patient medical history and health status, develop care plans for the treating providers to implement Review progress to care plans; identify patients at risk for a decline in health without greater adherence to care plans Support Data Quality Reviewers, LPN Reviewers and RN Reviewers in building their clinical knowledge and clinical decision making to enhance the quality of the initial reviews Coach APP new hires to help them in building their understanding of the role, tools, and technology As needed, support initial clinical and demographic data review generated by the system to prepare and finalize final care plan sign off and billing. Identify discrepancies in data and/or algorithm output; escalate through defined channels for correction. Identify potential gaps in care to complete the review. Communicate with Director of Clinical Review on issues regarding quality, system capacity, and resource requirements, facility and/ or provider feedback. Meet established standards for productivity, quality, timeliness, and customer satisfaction Performs all duties and responsibilities and adheres to the Nurse Practice Act. Protects patient information and adheres to standard of confidentiality with all patient information All other duties as assigned.