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National Clinical Vent Review Analyst at AdaptHealth, Remote (Global)

The National Clinical Vent Review Analyst will be responsible for evaluating all new ventilator start documentation for both new and existing ventilator patients within the organization. Additional responsibilities include a multidisciplinary approach to providing clinical guidance to the referrals and AdaptHealth Sales and Marketing regarding coverage determination. This position incorporates experience, education, and clinical knowledge, ensuring successful patient outcomes and referral satisfaction.

Essential Functions and Responsibilities:

• Knowledge of all applicable insurance guidelines related to eligibility of coverage and reimbursement.
• Develop and maintain a working knowledge of current makes and models of ventilators and the corresponding supplies.
• Timely review of all required documentation within the timeframe established by the insurance and company policy.
• Ensures all prescriptions are accurate and valid.
• Maintain ongoing relationships with customer service representatives and clinical contacts to ensure timely delivery and training of equipment.
• Communicate with AdaptHealth sales and marketing team and management; interact with external and internal customers in an appropriate and professional manner.
• Facilitates care coordinator within identified business areas within identified scope of practice.
• Ensures workflows, utilizes protocols and resources are provided to support service, patients, and customers.
• Assist with additional functions within the Adapthealth business umbrella as deemed necessary and appropriate within the scope of practice for a licensed clinical professional.
• Assistance with data collection and analysis for quality purposes will be expected.
• Maintain a standard of performance that prioritizes safety, quality and experience that coincides with the mission of the organization as well as identify key strategic or performance initiatives.
• Ensures professional, clinical standards, policy and evidence-based research will guide the process to ensure service and delivery of care.
• Provides additional support to AdaptHealth Sales Team, as identified to ensure all patient needs are being met and continuity of patient care is maintained.
• Participates in process improvement, professional development, peer development, peer review and shared program oversight.
• Comply with all applicable company policies, procedures, and patient protocols. Comply with all current government regulations and professional standards respecting patient care.
• Retain knowledge of and consistently adhere to procedures for the use of Personal Protective Equipment (PPE), infection control and hazardous materials handling.
• Maintain patient confidentiality and function within the guidelines of HIPAA.
• Complete assigned compliance training and other educational programs as required.
• Maintain compliant with AdaptHealth’s Compliance Program.
• Perform other related duties as assigned.

Competency, Skills, and Abilities:

• Decision making, analytical and problem-solving skills with attention to detail.
• Strong verbal and written communication
• Leadership skills with ability to manage in a multi-site environment.
• Strong organizational skills with ability to follow through.
• Ability to work independently as well as follow detailed directives.
• Ability to recognize weakness in existing systems and processes, track results, and offer creative solutions.
• Ability to prioritize and manage multiple tasks.
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction.
• Computer skills including knowledge of Microsoft Office applications.

Education and Experience Requirements:

• CRT or RRT (RCP) with state license, or licensed RN with equivalent experience
• Four years work related experience in health care.
• Prior DME care experience is preferred.
• Valid and unrestricted driver’s license

Physical Demands and Work Environment:

• Work environment may be stressful at times, as overall office activities and work levels fluctuate.
• Must be able to bend, stoop, stretch, stand, and sit for extended periods of time.
• Subject to long periods of sitting and exposure to computer screen.
• Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use.
• Must be able to lift 30 pounds as needed.
• Excellent ability to communicate both verbally and in writing.
• Ability to utilize a personal computer and other office equipment.
• May be exposed to angry or irate customers or patients.
• Physical and mental ability to analyze data and conduct research.
• Strong ability to communicate both verbally and in writing.
• Ability to work independently with little or no supervision.
• Must be able to drive and travel as needed.
• Physical and mental ability to provide clinical assessments.
• Metal ability to communicate both verbally and in writing.