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Job Description
Join Providence Health and Services as a Clinical Documentation Specialist RN, where you will play a crucial role in utilization management and quality improvement. This hybrid position allows you to work both onsite and remotely, focusing on enhancing patient care and operational efficiency.
Key Responsibilities
Evaluate appropriateness and medical justification of health services for MCO eligibles
Research, develop, and communicate implementation of Medical Policies
Facilitate Medical Policy Committee work
Provide medical treatment reviews, case management, and treatment interventions
Coordinate opportunities for Continuous Quality Improvement projects
Required Qualifications
Graduate from an accredited School of Nursing
Oregon Registered Nurse License upon hire
5 years of Clinical experience
2 years of Utilization review or quality assurance experience
Strong clinical background in orthopedics, neurology, and rehabilitation
Documented experience as team or project leader
Experience in medical literature search and analysis
Experience in provider profiling and data analysis
Experience in personal computer applications, database management, spreadsheets, and word processing
Preferred Qualifications
Bachelor's Degree or Master's Degree in Nursing
2 years of Medical case management
2 years of experience in managed care or in workers' compensation insurance
Benefits & Perks
401(k) Savings Plan with employer matchingHealth care benefits (medical, dental, vision)Life insuranceDisability insurancePaid parental leaveVacation and holiday time offVoluntary benefitsWell-being resources