Providence Health Plan · 22 hours ago

Quality Assurance RN - Administration Remote

Spokane, WA

Full-time

Remote

Mid Level

$42.69/hr - $67.58/hr

3+ years exp

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Responsibilities

Under the supervision of the Revenue Integrity Manager, the Clinical Data Reviewer (RN) improves data quality and appropriately risk stratify the populations in value based contracts and provide better patient care by reviewing medical records to determine if there are any gaps in documentation.

The Clinical Data Reviewer will query providers about any gaps to clarify the documentation to support and record appropriate ICD-10 diagnosis work.

An understanding of risk adjustment models and hierarchical condition category (HCC) coding is necessary.

Assists Population Health leadership in developing new data projects and elements for the collection, monitoring and reporting of both clinical and Quality Improvement outcomes.

Supports the department and staff by providing clear and concise technical assistance as needed.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Registered Nurse LicenseRisk Adjustment ModelsHCC CodingCertified Risk Adjustment CoderEpic ExperienceDegree in BSN3 years Nursing Experience