Quality Assurance--Nurse Practitioner (73583)

Mountain View Hospital • Idaho Falls, ID 83401

Posted 1 month ago

Job Description

JOB SUMMARY: Medical Provider, Assesses, Diagnoses, Plans, Implements treatments, and evaluates: Walk in patients, Imaging patients, and assists / collaborates with, and refers to, Internal Medicine when needed. Supervises and performs, when necessary, utilization review in accordance with all state and federal mandated regulations in order to evaluate the necessity, appropriateness and efficiency of medical services provided. Maintains compliancy with regulation changes, ensures cost effective and appropriate health care services are provided to all patients regardless of funding. Supervises Utilization Review, Case Management, and Social Services staff.

The Hospitals Advanced Practice Registered Nurse, Certified Nurse Practitioner

1. Assesses, diagnoses, plans, implements treatments, and evaluates clients with acute and chronic medical and mental health issues and minor injuries, by applying current evidence-based research findings relevant to the advanced nursing practice role.

2. Re-evaluates and provides follow-up care as necessary.

3. Performs office procedures consistent with medical staff privileges granted (minor laceration repair, biopsies, cyst or toenail excisions, nail trephination, incision and drainage, etc).

4. Orders, collects, performs, and interprets laboratory, radiological, and other diagnostic tests.

5. Prescribes and dispenses pharmacologic and non-pharmacologic agents pursuant to applicable state and federal laws.

6. Assumes responsibility and accountability for health promotion and maintenance.

7. Uses advanced practice knowledge and skills in teaching and guiding clients, families, and other health care team members.

8. Recognizes his/her limits of knowledge and experience and shall consult and collaborate with and refer to other health care professionals as appropriate.

9. Evaluates and provides appropriate stabilization for patients with acute serious medical conditions or injuries and facilitates transfer, as appropriate, to an emergency facility or an appropriate level of hospitalization.

10. Manages the clients care in a timely manner and maintains level of productivity.

11. Interacts with staff of other departments as part of the patient care process.

12. Performs required quality assurance steps in the patient care process.

13. Thoroughly and accurately documents every client encounter.

14. Bills appropriately for each client care encounter.

15. Interfaces, as appropriate and necessary, with other providers and medical personnel within and outside of Mountain View Hospital, whenever necessary, to ensure quality client care.

16. Interacts with insurers, adjusters, case managers, and other entities as necessary.

17. Performs other duties as necessary/assigned.

18. Institute and annually update Utilization Review Plan.

19. Participate in the Utilization Review Committee.

20. Acts as Quality Improvement Organization (QIO) Liaison.

21. Supervises Utilization Review and Case Management to ensure compliance with Centers for Medicare and Medicaid Services (CMS) guidelines.

22. Supervises the arrangement of appropriate services for the client, both during the patients stay and after discharge, utilizing all resources.

23. Supervise the justification of pre-admission, admission and continued stays per InterQual criteria, by utilizing the InterQual and discharge criteria for all payer



Education/Certification: Licensed Nurse Practitioner. Maintain current Idaho licensure. National Certification, Federal, DEA, and Idaho Board of Pharmacy certifications. Completes adequate CE/CME as required by licensure and certification. Maintains current certification in BLS, ACLS, and PALS. Works within the scope of practice as defined by the Idaho Board of Nursing. Maintains Medical Staff Privileges. Requires an NPI number.

Experience: Previous nursing experience as an APRN, CNP, or registered nurse (RN) in primary, acute, or intensive care required. Experience with a broad range of patients (ages, acuity levels, disease processes). Experience in Utilization Review and Case Management.

Equipment/Technology: Works with computers, diagnostic Equipment, and medical equipment.

Language/Communication: Communicates well with staff, clients, family members, outside entities, and other medical providers.

Mathematical Skills: Possesses adequate math skills to Calculate dosages and formulas.

Mental Capabilities: Requires a high level of diagnostic thinking, often rapid. Must be able to perform multi-tasking with frequent interruptions. Must be capable of on-the-spot problem solving. Maintains a strong knowledge of up-to-date clinical information. Must be flexible.

Interpersonal: Has the ability to inspire staff to tackle challenging work. Ability to recognize, understand, and address the needs of clients and family members on multiple levels. Ability to communicate well and inspire trust when encountering individuals of all cultures, levels of education, and walks of life. Ability to project a feeling of caring and concern to others.

Performance: Must be able to work efficiently and comply with daily demands. Works well under pressure and able to meet multiple and competing deadlines. Able to work as part of a team who share responsibility for the clients well-being and the hospitals operations. Understands the requirements of being a department of a hospital and complies with that level of quality.


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      Quality Assurance--Nurse Practitioner (73583)

      Mountain View Hospital • Idaho Falls, ID 83401

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