Clinical Documentation Specialist RN *Hybrid* Job at Providence Health and Services, Portland, OR

anBleG5PcnA4WktPK2tubnMvSWFZY2ZO
  • Providence Health and Services
  • Portland, OR

Job Description

Join Our Team as a Clinical Documentation Specialist RN!

Position: Clinical Documentation Specialist RN (Hybrid)

Are you ready to make a meaningful impact in healthcare? As a MCO Clinical Reviewer , you will play a vital role in ensuring the appropriateness and medical justification of health services for our members. This position focuses on:

  • Researching and developing Medical Policies
  • Facilitating Medical Policy Committee work
  • Conducting medical treatment reviews and case management
  • Promoting cost-effective medical care and early return to work in workers' compensation cases
  • Identifying opportunities for Continuous Quality Improvement projects
  • Engaging in provider profiling, benchmarking, and education

Work Environment: At Providence Health Plan , we embrace a hybrid work model for applicants residing in the greater Portland, OR area. You’ll have the flexibility to work from our Portland office or occasionally visit client sites.

Why Choose Providence Health Plan?

At Providence, our caregivers are not just valued—they're invaluable! Join us and thrive in a culture that prioritizes patient-focused, whole-person care. Here, your voice matters, and we believe in empowering our team to inspire and retain the best talent.

Required Qualifications:

  • Graduate from an accredited School of Nursing
  • Oregon Registered Nurse License upon hire
  • 5 years of clinical experience
  • 2 years of utilization review or quality assurance experience
  • Strong clinical background in orthopedics, neurology, and rehabilitation
  • Documented experience as a team or project leader
  • Experience in medical literature search and analysis
  • Experience in provider profiling and data analysis
  • Proficiency in personal computer applications, database management, spreadsheets, and word processing

Preferred Qualifications:

  • Bachelor's or Master's Degree in Nursing
  • 2 years of medical case management experience
  • 2 years of experience in managed care or workers' compensation insurance

What We Offer:

Our comprehensive benefits package is designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities.

Benefits include:

  • Retirement 401(k) Savings Plan with employer matching
  • Health care benefits (medical, dental, vision)
  • Life and disability insurance
  • Generous time-off benefits (paid parental leave, vacations, holidays)
  • Voluntary benefits and well-being resources

About Providence:

At Providence, we are committed to our promise: “Know me, care for me, ease my way.” Working with us means you’ll have the support you need to thrive in your career while helping others. With over 120,000 caregivers across 50 hospitals and 1,000 clinics, we are dedicated to serving our communities and advancing best practices in healthcare.

Equal Opportunity Employer: Providence is proud to be an Equal Opportunity Employer. We believe diversity makes us stronger and are committed to creating an inclusive workforce where everyone is valued and respected.

Position Details:

  • Requisition ID: [Insert ID]
  • Job Category: Documentation Management
  • Job Function: Quality/Process Improvements
  • Job Schedule: Full time
  • Job Shift: Multiple shifts available
  • Career Track: Nursing
  • Department: 5018 PRODUCT MCO OR REGION
  • Work Location: Providence Office Park, Portland
  • Workplace Type: Hybrid
  • Pay Range: $49.34 - $76.59

Join us at Providence Health Plan and be part of a team that truly makes a difference!

Job Tags

Holiday work, Full time, Shift work,

Similar Jobs

Russell Tobin

Business Analyst Job at Russell Tobin

 ...Business Operations Analyst Location: Warren, MI (hybrid, in office Tues-Thurs) Employment Type: W2 Contract, Full-Time Hours Pay Range: $25-30/hr. DOE An established organization is seeking a highly organized and detail-oriented Business Operations Analyst... 

Griffin Agency

Work from Home: Life & Health Insurance Opportunities Await! Job at Griffin Agency

 ...Who We Are : We are an insurance technology and distribution platform that is transforming the industry. We have developed a paperless...  ...than one minute. We are one of the top distributors of digital life insurance policies in the world. We have an in-house marketing... 

ViaSat

Systems Integration and Test Engineer Job at ViaSat

 ..., you will work closely with our lab and engineering teams to operate and maintain simulated commercial...  ...-mode tests in an agile, continuous integration environment. This role gives you the opportunity to test a sophisticated system from several personas, including Field... 

Safeway Oil Change & Automotive Services

Service Manager Job at Safeway Oil Change & Automotive Services

 ...Automotive Service Manager Safeway Oil Change & Automotive S ervice Employment Type: Full-Time| Compensation: $65,000 to $80,000 per year We are looking for an Automotive Diagnostic / Repair Technician to join our team! That wants a career and not just a job... 

Sylvan Learning Center - Lake Zurich, IL

Retired Teachers for Tutoring Job at Sylvan Learning Center - Lake Zurich, IL

We are hiring Retired Teachers as Part-Time tutors at our Lake Zurich/Barrington, IL and Schaumburg, IL locations!. We provide in-person tutoring for students K-12:* Reading/English teacher* Math teacher* Early Elementary Reading Teacher* Beginning Reading* Writing...