Medical Review Manager Jobs in Silver Spring, MD

Description
Description
LifeHealth, a federal government contractor, is seeking a Nurse Practitioner (NP) to conduct Medical Reviews of Medical Questionnaires, Fitness for Duty evaluations, and Review Medical Exam Records for job applicants.
Location:
Northern Virginia
Opportunity to Telework
Job Description:
NP to provide appropriate medical review of employee self- certifying electronic medical questionnaires, and, when needed, contact and question employees to obtain necessary information or to initiate the next steps of assessment. Determine if additional information is needed, contact employee to further discuss, and if still needed, collect information for further review. Using the appropriate medical guidelines, determine the next steps of assessment or clear the employee. NP shall also support candidate Equal Employment Opportunity (EEO) cases and litigation as directed.
ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO:
• The NP will work onsite at the headquarters and/or remotely* to perform medical review of employee completed electronic questionnaires.
o *NP can work remotely; however, they must be able to physically come to the office for medical exam review training (typically held in the first month) and at Government request. This is considered local travel and no reimbursement will be provided for travel. The core hours of operation are from 09:00 am - 15:00 pm.
• Receive electronic medical questionnaires presorted and identified as needing additional medical review
• Review the medical questionnaire following protocols, using medical guidelines and their medical knowledge to determine one of the two following actions:
• Contact employee to discuss medical concerns, followed by taking one of the actions:
• Receive requested medical information from employee's medical provider, reviewing information followed by taking one of the actions:
• Document process in medical records system
• Provide customer services within the guidelines
• Make a recommendation for improving process
• NPs will, as needed, conduct records-based fitness for duty evaluations (FFD) and FMLA reviews
• Complete monthly reporting as directed
• Performs other duties and responsibilities as assigned
QUALIFICATIONS:
• NP must possess an unencumbered NP license in the Commonwealth of Virginia.
• NP must have a BSN, and an MSN or Doctor of Nursing Practice (DNP).
• Must be a US Citizen
• Minimum of five (5) years of direct and relevant experience in clinical practice,
occupational health, and advanced case management, including experience in medical
review, fitness for duty evaluations, and review of complex medical determinations.
• Must not have been convicted of, pled guilty to, pled nolo contender to, or received probation before judgement for any crime other than a minor traffic violation, the record of which has not been expunged.
• Must not have had any professional licensure or certification withheld, suspended, revoked, or denied, and the
candidate must not have surrendered or allowed a professional license or certification to have expired or lapsed because of an investigation or disciplinary action

• Must be able to obtain a minimum National Agency Check with Inquiries (NACI) with Federal Bureau of Investigation (FBI) fingerprint check

§ Able to favorably pass a preliminary background check
§ Able to gain required access to facilities, information systems, and/or information subject to the security procedures set forth
KNOWLDEGE SKILLS & ABILITIES
• Work independently with minimal supervision
• Excellent verbal and written communication skills
• Mastery level application of occupational health principles and case management.
• Proficient in employee case management coordination, with a primary focus on utilizing medical knowledge and organizational protocols in reviewing externally assessed employee medical records and information for the purpose of case file preparation and recommendation of determination for review by physician or physician's medical designate.
• Experience following protocols in the collection and organization of employee medical and related documentation; answering medical and review process questions posed by internal and external stakeholders.
• Demonstrates aptitude for understanding medical guidelines, and experience associating the characteristics of medical conditions and treatments to ensure an appropriate recommendation of medical determinations.
• Experience in maintaining sensitive personal identification information (SPII) standards and confidentiality in handling protected health information.
• Exactness in maintaining records and writing case reports while documenting all contacts and outcomes related to case activity in system.
• Complete Workplace Violence Prevention training online
Physical Demands:
Position requires frequent standing or walking. Ability to access files, supplies and equipment. May need to move light equipment or supplies from one place to another.
Work Environment:
Work environment is generally favorable. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, chemicals etc. Subject to frequent interruptions.
Disclaimer:
The above position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
LifeHealth is an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.