It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
As a Medical Review Nurse Advisor at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve - a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions. Here are the details on this position.
Your role in our mission - Analyzes and applies policy to multiple situations including client meetings as well as suspended claims.
- Serves as the expert on State policy and provides necessary consulting services to the client.
- Responds timely to client referrals.
- Recommends approved modifications and/or new processes to maintain competitiveness in the industry. Identifies additional product/services opportunities in client organization and follows up with business development team.
- Applying nursing knowledge, skills, and policy in processing medical claims.
- Attending client meetings and acting as a consultant and expert on policy.
- Communication skills, engagement as part of a larger team.
What we're looking for - Must have two (2) years of professional nursing experience. Possession of a Master's Degree in Nursing may be substituted for one (1) year of the required experience.
- Must be a Registered Nurse licensed to practice in the State of California.
- Training and/or certification in wound and ostomy is preferred.
- Must have knowledge of professional nursing principles and techniques, hospital routines and an extensive knowledge of medical supplies and their uses.
- Ability to develop and apply business and consulting services.
What you should expect in this role - This is a part-time (30 hours per week) permanent regular salaried (W-2) employee position.
- Computer and other company-provided items.
- Monday through Friday work schedule.
- For all remote positions employees' Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.
- To Test your internet download and upload speed:
- Go to Google.
- Search for Internet Speed Test.
- Video cameras must be used during all interviews, as well as during the initial week of orientation if hired.
- Must have two (2) years of professional nursing experience. Possession of a Master's Degree in Nursing may be substituted for one (1) year of the required experience.
- Must be a Registered Nurse licensed to practice in the State of California.
- Training and/or certification in wound and ostomy is preferred.
- Must have knowledge of professional nursing principles and techniques, hospital routines and an extensive knowledge of medical supplies and their uses.
- Ability to develop and apply business and consulting services.
What you should expect in this role - This is a part-time (30 hours per week) permanent regular salaried (W-2) employee position.
- Computer and other company-provided items.
- Monday through Friday work schedule.
- For all remote positions employees' Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.
- To Test your internet download and upload speed:
- Go to Google.
- Search for Internet Speed Test.
- Video cameras must be used during all interviews, as well as during the initial week of orientation if hired.
- To Test your internet download and upload speed:
- Go to Google.
- Search for Internet Speed Test.
This position is intended for pipelining. We will accept applications on an ongoing basis.
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The pay range for this position is $65,000 - $80,500 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
