University of Massachusetts Medical School

Nurse Practitioner Advisor-DCS

University of Massachusetts Medical School • $90K — $120K *
Westborough, MA 01581In-Person
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Master's Level Degree of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
  • Nurse Practitioner Board Certified
  • 3-5 years of direct patient care experience
  • Experience with MassHealth or Medicaid (preferred)
  • Proficiency in Office Applications (preferred)

Responsibilities

  • Determine clinical and functional eligibility for disability benefits according to legal criteria
  • Review medical records and make approval or denial decisions on disability recommendations
  • Advise clinical personnel on case development and functional capabilities of applicants
  • Contribute to the implementation of quality improvement initiatives
  • Participate in team-based quality case reviews
  • Collaborate with clinical leadership on regulatory interpretation and policy development
  • Provide feedback on clinical policies and outcomes during training sessions

Benefits

  • Clinical guidance and oversight responsibilities
  • Opportunity to influence quality improvement initiatives
  • Collaboration with clinical leadership
  • Potential for professional development and training opportunities
  • Engagement in a significant role within the disability benefits evaluation process
Full Job Description
Overview

POSITION SUMMARY:

The Advisor is responsible for reviewing medical records, constructing functional capacity reports and deciding of disability for applicants seeking benefits based on disability. Advisors provide clinical guidance to staff. Advisors oversee the quality of reports and documentation produced by their peers and determine quality improvement initiatives as appropriate. Advisors shall obtain sign-off from a physician on decisions; when necessary.

Responsibilities

MAJOR RESPONSIBILITIES:

  • Responsible for determining whether an individual applying for benefits as a result of disability meets specific clinical and functional criteria established by federal and state law and regulation.
  • Review medical records, approves, or denies recommendations made by staff regarding the disability status of an applicant.
  • Advises clinical personnel regarding case development and determines the functional capability of an applicant based upon a comprehensive review of all records.
  • Contributes to quality improvement initiatives.
  • Participate in quality team case reviews.
  • Collaborate with clinical leadership in the interpretation of regulations, development of clinical policies and quality evaluations, provide feedback to peers and other staff regarding clinical policies and the outcomes of quality evaluations, and assist in the development and training.


Qualifications

REQUIRED QUALIFICATIONS:

  • Master's Level Degree of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
  • Nurse Practitioner Board Certified
  • 3-5 years of experience in direct patient care.

PREFERRED QUALIFICATIONS:

  • Experience with MassHealth or Medicaid
  • Proficiency in Office Applications


Additional Information

#LI-AC1

About University of Massachusetts Medical School

The University of Massachusetts Medical School (UMMS) is a world-class research institution with a uniquely collaborative spirit, that consistently produces noteworthy advances in clinical and basic research. The school is located in Worcester, Massachusetts and is part of the University of Massachusetts system. UMMS is dedicated to advancing the health and well-being of the people of the commonwealth and the world through pioneering advances in education, research, and health care delivery. The school is home to three Nobel laureates, 25 research centers, and a faculty of more than 1,200 physicians, scientists, and health care professionals.
Learn more about University of Massachusetts Medical School
Size
6,000 employees
Industry
Education, Government & Non-Profit
Founded
1894
* Ladders Estimates

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