Quality Review Nurse - MA (market wide)

Cityblock Health

Cityblock Health

This job is no longer accepting applications

See open jobs at Cityblock Health.
Quality Assurance
Massachusetts, USA
Posted on Thursday, February 8, 2024

#communityhealth #healthcare

About Us:

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:

The QRN reviews 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. Pivots to various tasks to support the QRN and ARN team, up to and including performing MDS assessments on members as needed.

Assessment Review

  • Utilize Assessment Backlog to prioritize assessments ready to be reviewed
  • Ensure all information within the MDS is correct, verify that all applicable BH/SUD codes have an associated research note
    • Research all available EHR’s to ensure any relevant codes not included by ARN are accurately documented
  • Review ADL & iADL documentation and cross reference to the Member Impression note
    • Reach out to ARN to clarify any discrepancies between what is documented in the MDS and what is reflected in the member impression note
    • Verify any services member is receiving and ensure accurately captured in MDS
  • Review care plan and ensure all relevant clinical information is reflected in the care plan, and anything not care planned for is explicitly documented in the member impression note as being declined to care plan

Operations

  • Utilize our care facilitation, electronic health record and scheduling platforms as needed to collect data, document member interactions, organize information, track tasks, and communicate with your team, members, and community resources

Requirements for the Role:

  • Graduate of an accredited school of nursing (R.N.)
  • 3 Years of experience
  • Certified in Basic Life Support for Healthcare Providers
  • Active RN License in the state(s) practicing Unrestricted Driver’s License
  • Comfortable using technology to support members without in-person contact (telephone and text etiquette, virtual visit platforms, etc.)
  • Understanding of how to use electronic health record systems and/or care facilitation platforms to ensure accurate documentation
  • Proficient in collecting member clinical and demographic data and documenting appropriately in a timely manner
  • 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
  • Strong problem solving skills - ability to collaborate with other team members to ensure member is in their appropriate rating category based on all available subjective and objective information
  • Use Clinical critical thinking to assist in reviewing the clinical quality of assessments, as well as assist with internal monitoring when support is necessary
  • Adaptable to change and prepared for frequent, fast-paced changes and shifting priorities
  • Willing and able to pivot to various tasks as needed in order to best support the needs of the department

What We’d Like From You:

  • A resume and/or LinkedIn profile

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.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

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.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

This job is no longer accepting applications

See open jobs at Cityblock Health.