Hospice Medical Review Nurse

We are looking for a compassionate, talented and experienced Hospice Medical Review Nurse that is eager to join an exciting, growing organization.

Working with Heart to Heart Hospice

At Heart to Heart Hospice, we provide “Compassionate Care, From Our Heart to Yours.”  Our employees enhance the lives of patients with life-limiting illnesses and their loved ones, during a time when compassionate care is needed most.  They say, “Home is Where the Heart is” and we want you to find your career home with Heart to Heart.  We are dedicated to making a difference in the lives of our patients and their families, and we offer individuals the opportunity to be associated with a caring staff and organization, while creating positive contributions in their community.

What You Will Do:

As our Hospice Medical Review Nurse, you will use your talent and abilities in many ways, including:

 
  • Review a medical record identifying qualifying information supporting hospice eligibility, patient decline and less than six month terminal prognosis based on the local coverage determinations.
  • Generate a written narrative summary letter using the information identified in the medical record validating hospice eligibility, patient decline and limited six month or less terminal prognosis which will be submitted to the Medicare Administrative Contractor (MAC) or government review agency.
  • Organize the information in the document imaging software as requested by the auditor for the additional development request and the appellate process required for packet submission.
  • Save and upload documents to the Shared Drive and E-Solution database – Maven.
  • Update and track the additional needed items list and distribute the items to the appropriate department member.
  • Maintain the physician signature and employee signature logs by agency in the shared drive.
  • Conduct all business activities in a professional and ethical manner.
  • Other duties as assigned.

What You Must Have:
 
  • Registered Nurse required (active state license)
  • Minimum of two (2) years of experience in Hospice nursing and preferably Quality/QAPI experience and two (2) years med-surg experience prior to hospice
  • Minimum of one (1) year of experience responding to ADRs and appellate process in hospice
  • Working knowledge of Local Coverage Determinants for Hospice (multiple states)
  • Working understanding of Medicare rules and regulations related to hospice
  • Ability to comprehensively utilize information in a medical record in developing a well authored letter to Medicare reviewers
  • Excellent language and writing skills
  • Ability to meet critical deadlines
  • Excellent computer skills (Microsoft office and Imaging Software), ideally has experience with Home Care Home Base and Maven.
  • Ability to travel 

Full Time Employee Benefits

At Heart to Heart Hospice we offer the opportunity for you to join a caring company that believes in the importance of supporting our team members so that they are free to provide exceptional compassion and care to our patients.  Heart to Heart Hospice offers a leading employment package that includes competitive pay, flexible positions and comprehensive benefit offerings including medical, dental, vision, short and long term insurance, PTO, paid holidays, 401(k) with matching, tuition assistance, continuing education, company cars to qualified individuals and much more.

It is this Agency’s policy to provide equal employment opportunities without regard to age, race, color, religion, military status, gender preference, sex, marital status, national origin or disability.

Hospice, RN, Chart, Audit, Review, Clinical Review, Quality, Quality, Compliance, Auditor, Surveyor, Training Manager, Area Clinical Manager, Clinical, Manager, Director,
 

This is a full time position

Visit Careers at Heart to Heart Hospice

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