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 and performs all additional duties as assigned.

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)

PROFESSIONAL COMPETENCIES

• High level of critical thinking and problem-solving skills
• Strong work ethic and overall positive attitude
• Effective communication skills including verbal and written
• Ability to manage time effectively, understand directions, and work independently in a fast-paced environment
• Demonstrated flexibility, organization, and self-motivation
• Highly adaptable to change

For individuals assigned to a location(s) in California, NeueHealth 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 $71,824.83-$107,737.24 Annually.
Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.