Collaborative Physician (MD or DO) - Chart Reviewer

Collaborative Physician (MD or DO) - Chart Reviewer

US-MO-Lake St Louis

Job ID: 2017-1865
Type: Contractor - 1099
# of Openings: 9
Category: MD Collab
Lake St Louis, MO

Overview

The Collaborating MD provides oversight and guidance to Nurse Practitioners and/or Physician Assistants based on individual state regulations. Oversight is gained through periodic chart reviews and follow up with the providers. The frequency and amount of oversight is determined on the state level and will vary each month based on how active the assigned provider is with their target population.

Responsibilities

• Enter into Written Collaborative Practice Agreements and/or a Collaborate Relationship with the CCS Practitioners, depending on state specific requirements;
• Provide supervision and collaborative oversight for CCS Practitioners who provide CCS Practitioner Services in the Service Area, consistent with the Collaborative Practice Agreements and any applicable Protocols, and in accordance with applicable state and federal law;
• Review a representative sample of CCS Practitioner Service records at least once every three months, or more often as required by law or by CCS, to evaluate whether the CCS Practitioner Services were provided congruent with applicable Protocols; provide results of such review to CCS and the applicable CCS Practitioner; and maintain copies on site for possible regulatory agency review;
• Be available to the CCS Practitioner for consultation, as needed, either on site or by electronic access, including but not limited to, telephone, facsimile and email, during normal business hours;
• Attend trainings and orientations arranged and required by CCS, if applicable, such events not to exceed once per month, and be available to participate in conference calls with CCS’s Medical Director as may be requested from time to time;
• Maintain such records and furnish such reports regarding provision of the CCS Practitioner Services, including monthly time records appropriately describing the Services rendered, in the form and at such times as required by CCS
• Maintain compliance with Inovalon’s policies, procedures and mission statement;
• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;
• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company;
• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function;
• We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.

Qualifications

• Active un-encumbered license to practice nursing;
• Nurse Practitioner Certification from either the ANCC or AANP; in Family, Adult, Gerentology or Emergency Medicine.
• Maintains current CPR certification
• Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:
• Hepatitis B
• Influenza
• MMR: Measles, Mumps and Rubella
• Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)
• Varicella
• Tuberculosis
• Home Health exp a plus
• Must be able to effectively communicate with elderly and chronically ill patients and families;
• Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial;
• Ability to multitask;
• Excellent customer service skills;
• Bi-lingual or multi-lingual a plus.

PIff9878cd735a-30210-37213352

Location: Lake St Louis, Missouri, US

Posted Date: 5/2/2025