Clinical Assurance Nurse

Confirmed live in the last 24 hours

Locations

Remote

Experience Level

Entry

Junior

Mid

Senior

Expert

Desired Skills

Management

PowerPoint/Keynote/Slides

Communications

Requirements

Associate's degree in Nursing, preferred
Minimum 3 years of experience in medical management clinical functions, clinical auditing, or clinical training
Working knowledge of Case Management and Quality Management practices
Risk Adjustment knowledge preferred
Microsoft Applications: Word, Excel, and Powerpoint Required. Visio, preferred

Responsibilities

Conduct clinical audits to ensure alignment with clinical standards; reporting and escalating potential risk exposure and researching quality concerns
Collects and analyzes data from Care Partners to assess outcome and operational metrics; to include facilitating external communication necessary to obtain required information related clinical performance
Prepares and conducts patient-level monthly clinical performance meetings based on the identified clinical domains impacting performance and ensures adherence to the standardized templated formats for agendas, presentations, clinical profiling, and minutes
Collaborates with clinical leaders to assess the status of process improvement initiatives impacting clinical performance
Coordinate special clinical assurance projects related to clinical management; to include, but not limited to operational support, community resource assessments, training, and education
Adheres to the Policies and Procedures set forth by NeueHealth
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer
Some travel may be required

Back to Career Site

Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.

SCOPE OF ROLE

The role of the Clinical Assurance Nurse is to promote quality, cost-effective outcomes for a population by facilitating
collaboration and coordination across care partners. The Clinical Assurance Nurse ensures clinical oversight and monitoring based on specified clinical domains. The role works closely with clinical leaders to identify and address opportunities for performance improvement and direct management of members.

ROLE RESPONSIBILITIES

Conduct clinical audits to ensure alignment with clinical standards; reporting and escalating potential risk exposure and researching quality concerns.
Collects and analyzes data from Care Partners to assess outcome and operational metrics; to include facilitating external communication necessary to obtain required information related clinical performance.
Prepares and conducts patient-level monthly clinical performance meetings based on the identified clinical domains impacting performance and ensures adherence to the standardized templated formats for agendas, presentations, clinical profiling, and minutes.
Collaborates with clinical leaders to assess the status of process improvement initiatives impacting clinical performance.
Coordinate special clinical assurance projects related to clinical management; to include, but not limited to operational support, community resource assessments, training, and education.
Adheres to the Policies and Procedures set forth by NeueHealth

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

Associate’s degree in Nursing, preferred
Minimum 3 years of experience in medical management clinical functions, clinical auditing, or clinical training,
Working knowledge of Case Management and Quality Management practices
Risk Adjustment knowledge preferred.
Microsoft Applications: Word, Excel, and Powerpoint Required. Visio, preferred

LICENSURES AND CERTIFICATIONS

Active and Unrestricted License as a Licensed Vocational Nurse (LVN) or Registered Nurse (RN)

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
Some travel may be required.

For individuals assigned to a location(s) in California, Bright Health is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant’s education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $69,555.75 - $104,333.62 annually.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; up to 21 days of PTO, 10 paid holidays, plus 2 floating holidays per year; and a lifestyle spending account.

We’re Making Healthcare Right. Together.

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:

Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.

Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.

Powered by Technology

We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

1,001-5,000 employees

Website

Affordable personalized health insurance

Company Overview

Bright Health's mission is to make healthcare right. They believe quality health insurance should be simple, personal, and affordable. So they design easy-to-understand plans with benefits you'll actually use. Benefit-packed plans and surprisingly low rates mean you can focus on staying happy and healthy.

Benefits

Compensation and retirement - Performance bonus, Stock Options, 401k plan, 401k matching, Commuter assistance plans
Health and wellness - Health insurance, Dental insurance, Vision insurance, Life insurance, Disability insurance, FSA (Flexible Spending Plan), EAP (Employee Assistance Program)
Vacation and time off - Unlimited time off, Paid holidays, Flexible working hours, Maternity benefits, Paternity benefits
Values and quality of life - Public Transportation, Bike parking, Employee groups and committees, Snacks and beverages

Company Core Values

Be brave - Challenge the status quo with curiosity, courage, and tenacity
Be brilliant - Deliver predictable excellence with a learning mindset
Be accountable - Live by your word, always
Be inclusive - Value all voices and contributions to achieve big things
Be collaborative - Fearlessly partner with all people