Nurse Practitioner

1 week ago

Jackson, Mississippi, United States Methodist Rehabilitation Center Full time

The NP Reviewer is a key member of the medical management team, responsible for evaluating pre-admissions screenings (PAS) completed by the Nurse Liaison team and reviewing medical records to determine the medical necessity and appropriateness of inpatient rehabilitation admissions. This non-clinical role requires the provider to apply clinical expertise and judgment in accordance with CMS guidelines, state laws, internal policies, and other payer source requirements. This position will also perform clinical appeals, peer to peer, for the clinical approval from payer to admit patient for inpatient rehabilitation. The ideal candidate will possess a strong understanding of inpatient rehabilitation criteria and excellent analytical skills.

  • Advanced Clinical Degree (NP) from an accredited institution.
  • Active, unrestricted NP license in the state(s) where the reviews are conducted.
  • Experience in Physical Medicine and Rehabilitation or related fields is highly preferred.
  • Minimum of 3–5 years of clinical practice experience.
  • Prior experience in utilization management, case review, or managed care is preferred.
  • Exceptional analytical and critical thinking skills.
  • Strong knowledge of CMS guidelines for Inpatient Rehabilitation Facilities (IRFs).
  • Excellent written and verbal communication skills.
  • Proficiency with electronic health records (EHRs) and other utilization management software.
  • Meticulous attention to detail and objectivity.

We Offer

  • Competitive pay
  • A comprehensive, flexible, benefit package to all full-time employees (32 hours plus per week)
  • Medical and dental coverage beginning the first of the month following 30 days of employment
  • 403b Retirement
  • Life insurance

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