Peer to Peer Advanced Practice Provider

UChicago Medicine

Illinois, United States6d ago

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Key details

Location: Illinois, United States
Work style: Onsite
Level: Mid level
Job type: Full-time
Experience: 3–6 yrs
Function: other
Focus area: other
Posted: 6d ago

Skills

prior authorization

About the role

Join the University of Chicago Medicine as a Peer-to Peer Advanced Practice Provider (Nurse Practitioner or Physician Assistant) .

The Advanced Practice Provider will be responsible for comprehensive direct patient care management and will manage a caseload of patients by exercising autonomous decision making in the assessment, diagnosis, and initiation of delegated medical treatments. The APP will provide healthcare and patient services that may include education, research, and clinical support, as well as complete administrative activities under the direction and supervision of the Director/leadership. The APP has acquired the knowledge, skills, and judgment necessary to assist the physician through organized instruction and supervised practice. 

The APP will support the prior authorization, pre-certification, and financial clearance processes for planned elective procedures and services, including surgery, advanced imaging, and other services requiring clinical review. Responsibilities include conducting peer-to-peer reviews with insurance companies, providing clinical support for authorization requests, assisting with clinical appeals, and collaborating with ordering clinicians to resolve authorization barriers. The APP will also educate clinicians on payer requirements, documentation expectations, and best practices to improve authorization outcomes, streamline workflows, and reduce preventable delays and denials of care

Advanced Practice Provider Essential Job Functions

80% virtual: Focused on peer-to-peer insurance authorization reviews - daytime business hours
20% clinical: Continued clinical practice within your selected specialty
Ability to exercise autonomy in medical decision-making, provide a broad range of diagnostic and therapeutic services
Strong communication with collaborating physicians to obtain clinical support for decision making
Experience: Minimum of three years of APP experience
Innovation: An opportunity to help build and shape a new team from the ground up

Nurse Practitioner Education and Experience Requirements:

Master’s of Science in Nursing
Current and/or eligibility for State of Illinois RN and APN licensure/registration 
Must be certified as a Nurse Practitioner by the ANCC or AANP
Must have or be able to qualify for Illinois and DEA prescribing numbers
At least 3 years of APN experience required

Physician Assistant Education and Experience Requirements:

Completion of an accredited (physician assistant) educational program 
Certification in ACLS and by the National Commission on the Certification of Physician Assistants (NCCPA) and current and/or eligibility for State of Illinois licensure/registration
At least 3 years of PA experience Required

Position Details

Job Type/FTE: Full-Time, 1.0 FTE
Shift: Day
Unit/Department: Center for Advance Care - Hyde Park
CBA Code: Non-Union