RN Investigator - 245952 - Medix : Job Details

Job Title: Complaint Intake / RN Investigator

Location: Remote but must be a NYS resident / reside in NY

OVERVIEW: Working at the direction of the New York State Department of Health (NYSDOH) Nursing Home Centralized Complaint Intake Unit (NH CCIU), you will function as a Complaint Intake and Triage Nurse Reviewer performing clinical reviews and triage complaints and incident reports for possible noncompliance, received via telephone, electronic or postal mail, or other forums. Perform reviews irrespective of the submission method, triage complaints by severity consistent with federal triage guidelines, perform data entry, and identify the appropriate actions consistent with federal triage protocols.

SUMMARY: Remote, will be taking complaints from across the state for nursing homes and beginning the process of investigation. They need strong interpersonal skills and an empathetic nature because they will be working closely with families. They need to be a clear communicator and understand how to work with other departments.

QUALIFICATIONS:

• Strong interpersonal.
• Excellent communication (verbal & written) skills.
• Ability to work independently with minimal supervision.
• Ability to relate effectively to providers, physicians, senior medical and administrative personnel and resident/patients.
• Basic computer skills, including working knowledge of all Microsoft Office products.
• The ability to obtain Surveyor Minimum Qualification Test Certification within 12 months of employment, required.
• Travel may be required to fulfill training requirements.
• Must have a valid driver's license.
• Must be a New York State resident.

EDUCATION & EXPERIENCE:

• New York State Registered Professional Nurse (RN).
• Two (2) years' experience performing utilization review, medical review, fraud investigations, surveillance or monitoring activities at the facility level, required.
• Three (3) years of clinical experience in a medical facility, preferably a nursing home, required.

****Must have 2 years of UM/fraud investigation and 3 years of clinical experience***

Pay: $41.92/hr

Hours: day shift M-F (37.5 hours)