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Peer to Peer Advanced Practice Provider

UCMChicago🇺🇸United States

Quick overview

SeniorityMid Senior
Employment typeFull Time
Work modeHybrid
LocationChicago, United States
ACLSNursingPatient Care

Job description

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

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