Quality Assurance RN - Accountable Care
Company: Providence
Location: Lacey
Posted on: October 19, 2024
Job Description:
Description Under the supervision of the Quality Integrity
Program Manager, the RN - Clinical Data Reviewer (HCC) 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 RN- Clinical Data Reviewer understands audit
requirements and governing policies and regulations related to
ICD-10 coding and clinical documentation integrity. This position
is an integral part of a record review process analyzing cases and
will query providers about any gaps to clinically validate or
clarify diagnosis criteria in the documentation and record
appropriate ICD-10 diagnosis coding. An understanding of risk
adjustment models and hierarchical condition category (HCC) coding
is necessary. Provides feedback and education to the HCC Coding
Auditors and providers based on the reviews. This position will
also be able to follow trends in ambulatory/outpatient clinic
documentation review, integrity, and coding and will be able to
identify and assess educational needs and then provide appropriate
training. Also, assists in creating educational materials for
coding changes, updated coding guidelines, and strategies. Assists
Population Health leadership in developing new data projects and
elements for the collection, monitoring and reporting of both
clinical and Quality Improvement outcomes. Providence caregivers
are not simply valued - they're invaluable. Join our team at
Providence Medical Group Southwest Washington and thrive in our
culture of patient-focused, whole-person care built on
understanding, commitment, and mutual respect. Your voice matters
here, because we know that to inspire and retain the best people,
we must empower them. Required qualifications:
- Bachelor's Degree or BSN
- Coursework/Training: Sufficient for RN licensure
- 3 years Nursing experience in a hospital or physician practice
environment
- Required upon hire: Washington Registered Nurse License
Preferred qualifications:
- Preferred upon hire: Certified Risk Adjustment Coder (CRC) Or
Why Join Providence? Our best-in-class benefits are uniquely
designed to support you and your family in staying well, growing
professionally, and achieving financial security. We take care of
you, so you can focus on delivering our Mission of caring for
everyone, especially the most vulnerable in our communities. About
Providence At Providence, our strength lies in Our Promise of "Know
me, care for me, ease my way." Working at our family of
organizations means that regardless of your role, we'll walk
alongside you in your career, supporting you so you can support
others. We provide best-in-class benefits and we foster an
inclusive workplace where diversity is valued, and everyone is
essential, heard and respected. Together, our 120,000 caregivers
(all employees) serve in over 50 hospitals, over 1,000 clinics and
a full range of health and social services across Alaska,
California, Montana, New Mexico, Oregon, Texas and Washington. As a
comprehensive health care organization, we are serving more people,
advancing best practices and continuing our more than 100-year
tradition of serving the poor and vulnerable. The amounts listed
are the base pay range; additional compensation may be available
for this role, such as shift differentials, standby/on-call,
overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a
retirement 401(k) Savings Plan with employer matching, health care
benefits (medical, dental, vision), life insurance, disability
insurance, time off benefits (paid parental leave, vacations,
holidays, health issues), voluntary benefits, well-being resources
and much more. Learn more at providence.jobs/benefits. About the
Team Providence Clinical Network (PCN) is a service line within
Providence serving patients across seven states with quality,
compassionate, coordinated care. Collectively, our medical groups
and affiliate practices are the third largest group in the country
with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN
is comprised of Providence Medical Group in Alaska, Washington,
Montana and Oregon; Swedish Medical Group in Washington's greater
Puget Sound area, Pacific Medical Centers in western Washington;
Kadlec in southeast Washington; Providence's St. John's Medical
Foundation in Southern California; Providence Medical Institute in
Southern California; Providence Facey Medical Foundation in
Southern California; Providence Medical Foundation in Northern and
Southern California; and Covenant Medical Group and Covenant Health
Partners in west Texas and eastern New Mexico. Providence is proud
to be an Equal Opportunity Employer. We are committed to the
principle that every workforce member has the right to work in
surroundings that are free from all forms of unlawful
discrimination and harassment on the basis of race, color, gender,
disability, veteran, military status, religion, age, creed,
national origin, sexual identity or expression, sexual orientation,
marital status, genetic information, or any other basis prohibited
by local, state, or federal law. We believe diversity makes us
stronger, so we are dedicated to shaping an inclusive workforce,
learning from each other, and creating equal opportunities for
advancement. Requsition ID: 316675 Company: Providence Jobs Job
Category: Clinical Quality Job Function: Quality/Process
Improvements Job Schedule: Full time Job Shift: Day Career Track:
Nursing Department: 3032 ACCOUNTABLE CARE WA Address: WA Olympia
1018 Capitol Way 301 Work Location: Union Heights-Olympia Workplace
Type: Remote Pay Range: $47.98 - $75.94 The amounts listed are the
base pay range; additional compensation may be available for this
role, such as shift differentials, standby/on-call, overtime,
premiums, extra shift incentives, or bonus
opportunities.PandoLogic. Category:Healthcare, Keywords:Quality
Assurance Nurse, Location:Lacey, WA-98509
Keywords: Providence, Lakewood , Quality Assurance RN - Accountable Care, Other , Lacey, Washington
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