MPF Federal is hiring a Remote Quality Review Registered Nurse to play a critical role in evaluating patient health information and determining outcomes for medical and specialty exams for military Service Members and Veterans. In this role, you will use clinical judgement to conduct reviews, collaborate via phone, and ensure all documentation meets regulatory and contractual requirements.
What You'll Do
- Navigate a proprietary electronic medical record system to evaluate and process patient health information.
- Conduct clinical review of examination documentation, test results, and assessments.
- Corroborate information via phone interview with Service Members and Veterans.
- Utilize clinical judgement to identify quality assurance issues and make recommendations.
- Collaborate with providers, Veterans, and Service Members via a nurse call line to ensure exams meet requirements.
- Identify emergent behavioral health issues and initiate intervention when necessary.
- Interpret and document diagnostic test results.
- Educate and support providers, Veterans, and Service Members on navigating medical history and prior claims.
- Answer calls in the Clinical Operations Review queue regarding medical or specialty exams.
- Complete system-generated tasks to process exam documentation.
- Interface via telephone and email to retrieve required Disability Benefits Questionnaire information and provide education.
What We're Looking For
- Accredited Associate’s Degree in Nursing (ADN) OR Bachelor’s Degree in Nursing (BSN).
- Current RN license in your state of residency.
- Ability to type 40 words per minute.
- 5+ years of experience in a clinical environment as a Registered Nurse.
- Experience working in an Electronic Medical Record system.
- Understanding and knowledge of regulatory standards and their application.
- Proficient computer skills including Microsoft Office programs and database experience.
- Ability to work Monday through Friday, either 8:00am to 5:00pm CT OR 10:00am-7:00pm CT.
- A distraction-free, dedicated home office space; regular child or dependent care arrangements.
- Access to high-speed internet (cable, fiber optic) and a hard-wired Ethernet connection (no Wi-Fi only, satellite, or radio).
- A quiet, distraction-free home office space with a door for HIPAA compliance.
- Must be a U.S. Citizen.
- Ability to pass a Public Trust Background Check & Drug Screening per federal guidelines.
Nice to Have
- Experience navigating Microsoft Teams.
- Home Health or Hospice care experience.
- Experience reviewing medical disability claims.
- Knowledge or experience in: Clinical quality assurance, Auditing and compliance, Education of clinical staff, Clinical documentation improvement.
- Experience with Behavioral Health, TBI, PTSD and/or working with Veterans.
- Military experience.
Technical Stack
- Proprietary electronic medical record system
- Microsoft Office programs
- Microsoft Teams
Benefits & Compensation
- Compensation: $35.00 per hour
- Medical benefits
- PTO
- Holiday pay
Work Mode
This is a fully remote position.
MPF Federal is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status or on the basis of disability.
