Insurance Nurse Reviewer Jobs in Indiana (NOW HIRING)

Provides support to Vice President of Long Term Care and the Director of Quality Review gathering clinical data , formulating reports and conducting statistical analysis for the Long Term Care (LTC) Division.  Managing datasets  and provides data quality assurance and identifying needs to inform leadership in health-related decisions.  Assists in collection of Capital related financial invoices from managing partner.  Accompanies and participates as a member of the LTC Quality Review Team on site visits to the HHC Nursing Homes as assigned.

Responsibility 1: 50%
Collaborates with the Vice President and Director of Quality Review to design, conduct and interpret statistical analyses and determine quality indicators to monitor and report via the various data sources internal and external for the nursing homes and assisted living facilities owned and operated by HHC.  
Manages and maintains datasets, providing quality assurance and identifying needs for information to inform health related decisions.  Assists in preparation of reports and presentations on Long Term Care issues and statistics for the HHC Long Term Care Committee to aide in the oversight of the HHC owned Long Term Care Facilities.  
Extracts and interprets data and reports in a format that a variety of LTC, financial and medical personnel can use. 
Assists in the completion and follow up of any requests or directives resulting from the LTC Committee meetings as assigned.
Works with managing partner to obtain data analysis for review.

Responsibility 2: 40%
Participates as a member of the quality review team on assigned facility site visits.
Performs various auditing/review activities during the site visits including but not limited to:  medication administration observations, wound care and treatment administration, personal care services, meal service, clinical record reviews and review of nursing management records.  
Prepares data for the quality review team prior to the facility site visits to assist in determining specific areas to review. 
Performs various auditing/review activities during the site visits as assigned.  
Assists in the preparation of a written site visit report following each facility visit in cooperation with other quality review team members

Responsibility 3:  10%
Must be detail oriented, able to adhere to deadlines, deal with frequent interruption and regular requests for assistance from department staff and have good customer service skills for addressing concerns and interacting with facility residents and personnel on site visits.
Maintains confidentiality of all client records and information as specified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Serve as a driver on facility site visits out of town when necessary, using a LTC Department Van or personal vehicle (with approval and appropriate mileage reimbursement).
Other Duties and Responsibilities:
Works with LTC Sr. Financial Analyst responsible for financial and quality analysis for LTC Division.
Participates in the compilation, completion and distribution of quarterly and other reports prepared for the HHC Board of Directors Long Term Care Committee.
 

Registered nurse (RN)
Experience with computerized health data analysis, and data management

Good judgment and discretion in communication (written, verbal and non-verbal).Must be able to prioritize work, meet deadlines, and work well under pressure.
Flexibility to adjust to changing program/department needs and activities.
Strong skills in programming, including data management and data analysis
Statistical knowledge
Excellent verbal and written skills.
Must be proficient with Microsoft Office, Word, Excel, Power Point, Internet Explorer, and all usual and customary office equipment.
Must possess the ability to work independently, and as part of a team.
Must be able to display good customer service skills
Must be able to take initiative and prioritize workload.
Must be proficient in proof reading skills
 

MENTAL/VISUAL/PHYSICAL STRAIN:
Unconfined sitting 75%
Confined sitting 15%
Standing or walking 10%
Steady use of hands or fingers - Typing and filing 85%
Lift, carry, etc. with arms and legs - 15%
Ability to perform driving functions in normal course of workday with confined sitting for several hours at times