Master's Level Degree of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) required.
Nurse Practitioner Board Certified is essential.
3-5 years of direct patient care experience needed.
Experience with MassHealth or Medicaid is preferred.
Proficiency in Office Applications is a plus.
Responsibilities
Determine eligibility for disability benefits based on clinical and functional criteria.
Review medical records and approve or deny staff recommendations on disability status.
Advise clinical personnel on case development and assess applicant functional capability.
Contribute to quality improvement initiatives within the organization.
Participate in quality team case reviews to enhance service delivery.
Collaborate with clinical leadership on regulations and policy development.
Provide feedback and assist in training related to clinical policies and quality evaluations.
Benefits
Comprehensive health insurance options.
Retirement savings plan with employer contributions.
Professional development opportunities and training.
Flexible work schedule options.
Supportive work environment focused on quality improvement.
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
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.
