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Quality Review Nurse

Company: Cityblock Health, Inc
Location: High Point
Posted on: January 7, 2022

Job Description:

Clinical Manager/Admin opening in High Point, North Carolina. This and other rn jobs brought to you by NursingJobCafe.com

#communityhealth #healthcare

About Us: #communityhealth
Cityblock Health is the first tech-driven provider for communities with complex needs-bringing better care to where it's needed most, block by block. Founded in 2017 on the premise that "health is local" and based in Brooklyn, we are backed by Alphabet's Sidewalk Labs along with some of the top healthcare investors in the country.
Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.
In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.
Over the next year, we'll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.
Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.
Our Values:

Aim for Understanding
Be All In
Bring Your Whole Self
Lean Into Discomfort
Put Members First

About our Team:
We employ a field-based, home-based care model and are committed to meeting members where they are--in their homes, in their community, and in our Hubs. You will go above and beyond to connect with Cityblock members in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day.
About the Role:

You will work in a radically different model of healthcare
Expect collaboration, shared-decision making, and partnership across clinical and non-clinical care team members, including our large team of Community Health Partners
Review MDS Assessments for clinical accuracy and appropriate coding to ensure members are receiving the best care possible as well as appropriate stratification and C-Rating determination.
This role is primarily remote, but may take you into the community. You may occasionally meet with members in their homes, neighborhoods, to complete HRA Assessments as necessary
Use Clinical critical thinking to assist in reviewing the clinical quality of assessments, as well as assist with internal monitoring when support is necessary
Ensure rating categories are accurate to member's most recent Comprehensive HRA assessment
Utilize our custom-built care facilitation platform, Commons, and the market's EMR to collect data, document member interactions in the field, organize information, track tasks, and communicate with your team, members, and community resources

Requirements for the Role:

  • Active, unrestricted Registered Nurse license in the state in which you are seeking employment with Cityblock
  • You have 3+ years of experience providing clinical services to Adult and Geriatric individuals with co-occurring chronic medical and behavioral health conditions
  • Work a full-time 40 hour week, Monday-Friday 9am to 5pm ET, consisting of team meetings, case conference, supervision, and field-based independent clinical and co-visits
  • Experience and comfort working within an interdisciplinary care team, and specifically working alongside community health workers and care coordination team members
  • Familiarity and willingness to travel within your community (home-based member visits)
  • Have experience clinically reviewing assessments to maximize member care and ensure correct c- rating capture for assessments submitted to the Virtual Gateway
  • Are comfortable performing assessments both telephonically and in the home to support additional assessments when necessary
  • Have the clinical experience to assist with internal monitoring and comfortability with contract regulations to determine if contract requirements are being met
  • You have an unrestricted driver's license and vehicle for daily use

    How We Define Success:

    Review between 20 - 30 MDS assessments per day for clinical quality as well as appropriate C- Rating categorization
    Assist with submission if backlog of submission forms
    Ability to lean in to identify Change in Status, Pseudo and various types of "off cycle" assessments
    Prioritize assessments based on type and due date in order to maximize reimbursement
    Assist with internal monitoring of 5 - 10 cases per month when support for Senior Associate Care Quality is necessary
    Assist with completing Comprehensive HRA in the field or remotely occasionally when lean in is required

    Nice to Have, But Not Required:

    Experience coordinating multi-disciplinary care for members with multiple complex medical and social conditions
    Experiencing caring for individuals with criminal justice involvement
    Experience in hospice, acute care, and/or care management
    Bachelor's degree preferred
    Experience with Minimum Data Set (MDS-HC) assessments

    What We'd Like From You:

    A resume and/or LinkedIn profile
    A short cover letter, please!

    Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

    Covid 19 Update - Please Read:
    Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

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Keywords: Cityblock Health, Inc, High Point , Quality Review Nurse, Healthcare , High Point, North Carolina

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