Clinical Reviewer D.C. Skilled Nursing Facility

Comagine Health is looking for a RN who enjoys working with multiple external partners to support our growing team in Washington, DC.

This role will perform quality reviews of continued stays for long term care facilities in the Washington, DC area, in addition to working from home.

This position will work 3 days a week at a nursing facility and telework 2 days a week. Hours scheduled may be flexible within the timeframe of 8 : 00 am to 6 : 00 pm, ET.

You will be visiting nursing facilities in the DC and Maryland area. Candidates can live in the DMV area.

Who is Comagine Health?

Comagine Health is a non-profit consulting firm that seeks to improve health and to increase the effectiveness and quality of health care.

We support providers, plans, purchasers, and consumers, and offer services to state and federal agencies and others to help them better manage health care under the existing system and to assess, plan for and implement broader system transformation.

We collaborate with academic, government, and nonprofit partners on initiatives funded by NIH, CDC, AHRQ, BJA, SAMHSA, and other funders.

In short, we are changing healthcare at a fundamental level.

What you'll be doing for us :

Performing quality and utilization management reviews of residents’ continuing need for services and acuity level.

Ensuring that care plans and other documentation satisfy multiple regulations including but not limited to PASRR, MDS, Medicare, Medicaid, and other standards.

Perform onsite evaluation reviews for our provider partners in Washington, DC and Maryland

You will be visiting nursing facilities in the DC and Maryland area. Preferred candidates will live in the DMV area.

Required Skills :

• Demonstrated expertise in Quality Improvement and Utilization Management best practices
• Ability to organize and coordinate multiple simultaneous tasks in a team environment
• Experience with Medicaid and Medicare evaluation criteria strongly preferred
• Expertise with PASRR, MDS, and continued stay evaluations
• Familiarity with at least one medical management application (Jiva preferred)
• Reliable transportation to perform onsite visits

Required credentials and experience :

A degree or diploma in nursing or social work

Current, active, unrestricted RN licensure in Washington, DC or the ability to obtain one within 90 days of employment OR a Licensed Independent Clinical Social Workers (LICSW)

2+ years of clinical (direct patient care) work experience.

2+ years’ experience with admission screening and care planning for patients in Long Term Care facilities

1+ years of MDS or continued stay utilization review experience preferred.

Salary Range : $80,000 - 95,000

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.

We offer a competitive pay and benefits package plus employment with Comagine Health qualifies if you apply for the Public Service Loan Forgiveness (PSLF) Program!

If this sounds like a good showcase of your strengths and experience, let’s have a chat about why you might like to do these things for us.

We are happy to share additional details about the full job description, salary, and benefits, and tell you more about the inspiring work our teams are doing around the country.

Required Skills

Required Experience