Remote Nurse Practitioner

Peer Review for Quality Management may only be used for improving the quality of health care or utilization of health care resources in VA medical facilities. Its primary focus is whether the clinical decisions and actions of a clinician during a specific clinical encounter met the standard of care.

MUST HAVE EMERGENCY MED EXPERIENCE

Provider must have access to their own computer to complete online training, complete written reviews using MS word software, be able to access VA EMR system to review medical records, and be able to access Maximus’s secure email system to receive encrypted emails.

Provider has the ability to accept or decline cases; must do so within 24 hrs. Once accepted the review must be submitted within 3-5 business days, expedited cases are within 24 hours.

Minimum Qualifications: • Active license • 20 hours of direct patient care per month • Board Certification • MUST have National Provider Identifier (NPI) number • CANNOT be a VA employee, active duty military, or provide care in military facilities • 3 year experience in appropriate specialty post training (non-MD/DO)

**Volume of cases vary between 0-10 cases per month, dependent on the types/amounts of cases received by the VA.** ***Providers will be required to obtain a Personal Identify Verification (PIV) card and fingerprints, project will support with this requirement.*** ****Provider will complete two credentialing processes. One for Maximus and One for VA CPR. If you have any questions please feel free to reach out at your convenience. Thank you for your support, we look forward to working with you!

(VACPR) Rate Description of Service Completion Time

$60/cs Audit Review 30 min-1 hour $100/cs Clinical Appeals (rare) 30 min-1 hour $50/cs Executive Summary Reports 30 min-1 hour $100/cs Facility-Requested Review 30 min-1 hour $150/cs Medical Advisory Opinion 2-3 hours $50/cs Quality Review-Audit Review 30 min-1 hour $50/cs Quality Review-Facility Requested Review 30 min-1 hour $50/cs Quality Review-Routine Management Review 30 min-1 hour $135/cs Quality Review-Medical Advisory Opinion 30 min-1 hour