Data Reporting and Cost Containment Corporation (DRCC)

Data Reporting and Cost Containment Corporation provides consulting, auditing and data reporting services that partners with health systems and payor clients. We provide our clients with the tools, services and advice they need to thrive in the current complex and uncertain pluralistic payment environment and achieve visionary, organizationally relevant results.

 DRCC has expertise in all aspects of population health, strategy, delivery system development, payment systems reform, workforce development and population health management support services, including peerless analytics and performance improvement. Permanent, contract/temporary consultants, coders, and medical record reviewers, DRCC helps the healthcare industry find exceptional talent professionals for any business working in the areas of population health, HEDIS, and HCC Risk Adjustment Coding.

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Clinical Reviewer WA L&I

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Clinical Reviewer WA L&I LinkedIn Twitter Email Message Share Category Care Management Job Location Remote Tracking Code 134769 Industry Health Care Job Level Mid Career Position Type Full-Time/Regular Years of Experience Not Applicable We are seeking a remote Clinical Review RN to join our team supporting Washington State's Labor & Industries department. At Comagine Health, our utilization management best practices assure that patients receive the right care, in the right setting, at the right time, thereby avoiding the overuse, misuse and underuse of health services. We provide web-based utilization reviews and targeted review programs based on extensive data analysis. Because of our contractual requirements for RN reviewer coverage until at least 5:00 pm Pacific Time, Nurses who reside in the Pacific or Mountain time zones are preferred. Who is Comagine Health? Comagine Health is a national, nonprofit, health care consulting firm. We work collaboratively with patients, providers, payers, and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. As a trusted, neutral party, we work in our communities to address key, complex health, and health care delivery problems. In all our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics, and research. We invite our partners and communities to work with us to improve health and redesign the health care delivery system. Some of what you'll be doing: <ul><li>Participate in a multi-disciplinary team to improve the quality of healthcare for individuals and populations. </li><li>Apply nationally-recognized clinical criteria and guidelines to determine the medical necessity of inpatient admissions, outpatient procedures, and other healthcare services. </li><li>Consult with physicians or refer cases to others, when indicated. </li> </ul> Competencies: <ul><li>Intermediate MS Office Suite proficiency. </li><li>Have a natural curiosity and desire to learn with attention to detail. </li><li>Ability to work independently with minimal supervision in a quality or productivity-driven and team-oriented environment. </li> </ul>Required Qualifications: <ul><li>Degree or diploma in nursing (an equivalent combination of education and/or work experience in a related field may be substituted.) </li><li>Current, active, unrestricted RN license in Washington state. </li><li>5 years of clinical (direct patient care) experience or ICU and/or ER experience. </li><li>1 year of utilization review (or other medical management experience.) </li> </ul> Nurses who reside in the Pacific or Mountain time zones are preferred. Salary Range: $83,000 - $115,000 The salary range posted reflects the range that Comagine is willing to pay for this position. Salary is determined by many factors, including but not limited to geographic location of where the employee will perform their job duties in addition to their knowledge, skills, education, and relevant work experience.

Comagine Health

Clinical Reviewer WA L&I

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