Top 21 Rn work from home Jobs in Maine

Remote Clinical Documentation Improvement Nurse - Certified
Martin's Point Health Care —Portland, ME
- $86,926.10 - $107,379.30 a year
- Full-time
- Remote
- Nursing
- RN License
- Research
- Health insurance
- Dental insurance
2d
Clinical Care Rep RN
InterMed, P.A. —South Portland, ME
- $33.34 - $48.31 an hour
- Remote
- Nursing
- RN License
- Urgent Care
Quick Apply
4d
Utilization Management Nurse Consultant-1
CVS Health —Maine
- $26.01 - $74.78 an hour
- Weekends as needed
- Remote
- Nursing
- RN License
- Computer literacy
- Health insurance
- Dental insurance
4d
RN Readmission Manager, Payment Integrity
Centene Corporation —Maine
- $87,700 - $157,800 a year
- Full-time
- Remote
- Nursing
- RN License
- 3 years
- Paid holidays
- Health insurance
11d
Quality Manager - Registered Nurse
Liberty Healthcare Corporation —Lewiston, ME
- $90,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Experience working with individuals with disabilities
- Paid holidays
- Dental insurance
Quick Apply
Utilization Management Nurse Consultant - Medicare - EST/CST
CVS Health —Maine
- $26.01 - $68.55 an hour
- Weekends as needed
- Remote
- RN License
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
4d
Registered Nurse (RN) - Walk-in Care
MaineHealth —Brunswick, ME
- $34.35 - $46.46 an hour
- Part-time
- Remote
- Nursing
- Medication administration
- RN License
- Paid parental leave
- Parental leave
Pediatric Clinical Care Representative RN
InterMed, P.A. —Portland, ME
- $33.34 - $48.31 an hour
- Remote
- Nursing
- RN License
- Urgent Care
Quick Apply
3d
Quality Practice Liaison (Must be licensed in Arizona or Multi-State)
CVS Health —Maine
- $54,095 - $155,538 a year
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
11d
Clinical Specialist for Wound Care Supplies RN LPN
aSure Wound Solutions —Portland, ME
- $75,000 - $85,000 a year
- Full-time
- Remote
- RN License
- Mid-level
- 3 years
- Travel reimbursement
- Paid holidays
Quick Apply
Clinical Support Manager, Advisory Services (RN/LPN)
Sound Physicians —United States
- $75,000 - $85,000 a year
- 10 hour shift
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Health insurance
Quick Apply

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Remote Clinical Documentation Improvement Nurse - Certified

Martin's Point Health Care -
Portland, ME

Apply Now

Job Details

Full-time
$86,926.10 - $107,379.30 a year
2 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
Volunteer time off

Qualifications

Nursing
RN License
Employee relationship building
Bachelor's degree
Bachelor's degree in nursing
Nursing

Full Job Description

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

Position Summary

As a member of the GA Programs team, the Clinical Documentation Improvement Nurse partners key stakeholders within the health plan, delivery systems, and provider network to develop and implement processes and best practices to support accurate diagnostic coding and attention to gaps in care as it relates to Medicare Advantage Risk Adjustment. This role is also responsible for reviewing clinical documentation to support HEDIS, and to participate in the HEDIS medical record abstraction process. The Clinical Documentation Improvement Nurse is responsible in assisting the provider community to improve the overall accuracy, quality and completeness of clinical documentation.

Job Description

Key Outcomes:

Facilitates recommendations for improvement to clinical documentation through extensive interaction with key stakeholders in the delivery system and participating provider network to ensure the accuracy of the documentation and coding reflective of the reviewed services rendered.
Ensures the accuracy and completeness of clinical information used for measuring and reporting outcomes and confirms accuracy of diagnosis codes on submissions to the Centers for Medicare and Medicaid Services (CMS).
Provides education as it relates to quality and risk adjustment documentation and reporting in the delivery system, and participating provider network
Identifies trends, develops and executes action plans to increase clinical documentation accuracy and capturing of risk adjustable codes
Supports accreditation and regulatory compliance by evaluating process effectiveness, identifying and acting on improvement opportunities, and ensuring that all HEDIS requirements are met
Ensures compliance for all HEDIS quality audits and maintain all data and process controls
Manages internal and external relationships to promote positive working relationships and advancement of HEDIS and Risk Adjustment clinical documentation and coding reporting initiatives
Serves as risk adjustment coding subject matter expert from a clinical perspective and works collaboratively with management team to strategically plan and execute risk adjustment coding efforts to yield desired outcomes
Research and understand CMS and other regulatory and reputable risk adjustment publications to assist in development of best practice policies and creation of educational materials such as coding newsletters for distribution to providers with the most up to date guidelines and changes. Ensures the completeness and accuracy of the clinical documentation by reviewing clinical records, identifying gaps or inaccuracies, formulating credible clarifications and communicating with providers to clarify clinical diagnoses, ICD 10 code selections and supporting documentation.
Provides training to providers, practice leadership and designated staff to facilitate accuracy of clinical documentation and risk adjustment coding and to improve methodologies to support data integrity.
Reviews clinical documentation, identifies incomplete or inaccurate information for clinical relevance. Works with key stakeholders in a timely manner to ensure points of clarification are recorded in medical records.
Keep abreast of Medicare Advantage program and how it impacts payment, knowledge of pathophysiology and disease process.
Knowledge of value-based purchasing and other quality metrics affecting the clinical documentation integrity program.
Reviews and analyzes population data and metrics to inform improved coding outcomes
Identifies gaps in clinical operational structure between current and desired state
Develop monitoring tools to track successes and challenges in the CDI program in order to facilitate process improvements
Performs all other related duties as assigned

Education/Experience:

Bachelor’s Degree in Nursing required
Current RN license in good standing required
5+ years’ clinical experience, preferably in geriatrics
2 years of clinical coding experience with strong attention to detail and a high level of accuracy preferred
Ability to speak and provide presentations and education to small and large groups alike
Ability to work a flexible work schedule and willingness to travel (locally) as determined by business need
One or more of the following Licenses/Certifications required: CDI, CPC, CPC-H, CPC-P, CRC, CCS, CCS-P, CPMA

Skills/Knowledge/Competencies (Behaviors):

Knowledge of HEDIS, abstraction concepts, Medicare Risk Adjustment preferred
Ability to assess population health needs and define health improvement priorities
Excellent verbal and written communication skills required
Self-motivated and accountable for project coordination and follow-through
Strong organizational and planning skills required
Must meet deadlines and produce accurate work product
Must be able to handle multiple tasks at the same time
Must work well independently
Maintain strong clinical knowledge and understanding of Evidenced-Based Practice principles
Define and educate regarding appropriate sources for standards of care
Ability to review and analyze population data and metrics to inform development of programs
Create, build and maintain relationships in order to improve performance and establish trust and maintain creditability throughout the organization
Impact and influence: ability to make a difference
Demonstrate adaptability and flexibility in the face of changing demands.
Demonstrate willingness to perform additional tasks as assigned
Display initiative to improve relative to job function.
Contribute ideas to help improve processes and abstracting data
Demonstrate an understanding of and alignment with Martin’s Point Values.

Pay Range: $86,926.10 - $107,379.30 The pay range above reflects the anticipated base pay range based on a full-time position. Actual compensation will be determined based on factors such as experience, skills, qualifications, and other job-related considerations. Employees may also be eligible for additional compensation, including incentive or commission-based programs, where applicable and subject to the terms of the relevant plan. In addition to base compensation, we offer a comprehensive benefits package including medical, dental, vision, retirement savings with employer contributions, paid time off (including volunteer time off!), pie day, and other employee benefits.

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected]

Do you have a question about careers at Martin’s Point Health Care? Contact us at: [email protected]

Apply Now

Refine Your Search

rn work from home jobs in maine

Remote Clinical Documentation Improvement Nurse - Certified

Clinical Care Rep RN

Utilization Management Nurse Consultant-1

RN Readmission Manager, Payment Integrity

Quality Manager - Registered Nurse

Utilization Management Nurse Consultant - Medicare - EST/CST

Registered Nurse (RN) - Walk-in Care

Pediatric Clinical Care Representative RN

Quality Practice Liaison (Must be licensed in Arizona or Multi-State)

Clinical Specialist for Wound Care Supplies RN LPN

Clinical Support Manager, Advisory Services (RN/LPN)

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I want to receive the latest job alert for rn work from home in maine

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Position Summary

Job Description

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

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