Remote Hybrid Registered Nurse, Contract, CA

Maximus

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About the job

**We are looking for a contract Registered Nurse (RN) Reviewer/Surveyor for a Semi Remote, 1099 role in California**

Description:

  • CA-DMHC Med Survey performs routine (once every three years), follow-up and non-routine (for good cause) surveys of its licensed managed health care plans to ensure the plans meet their obligations under the law and consumers have access to the high-quality health care to which they are entitled. DMHC has oversight for commercial and some Medi-Cal (Medicaid) managed health care plans.
  • Layman Terms: The California Department of Managed Health Care (DMHC) conducts regular surveys of health care plans to make sure they are following the rules and laws and providing good-quality health care to people. These surveys happen every three years, and sometimes they do extra ones if there’s a good reason. DMHC oversees both commercial health care plans and some Medi-Cal (Medicaid) plans.​

  • During these surveys, they look at different areas to check how well the health care plans are doing. They have different people (called surveyors) who focus on specific parts. For example, some surveyors are medical doctors, while others are registered nurses/RNs or other clinical staff.

Minimum Qualifications:

• Active RN license

• 3 Years experience

• Audits or reviews is a plus

California Manage Health care systems (Must Have)

Training:​

· Paid training as needed is provided.

Deliverable:

· Links Surveyor will be working as an independent consultant to perform surveys of California managed health care plans to determine compliance with state law. Each survey is conducted in three phases: pre-onsite, onsite, and post-onsite. ​

· Specifically, the surveyor is responsible for: ​

· Pre-onsite: Electronic review and completion of pre-survey paperwork utilizing CA-DMHC audit tools: work includes review of plan documents and completion of Technical Assistance Guide (TAG), review of plan files and completion of File Review Worksheet (FRW), preparation for onsite interviews. There is at least one pre-onsite meeting with the client prior to going onsite. ​

· Onsite: Traveling onsite to the health care plan offices for approximately 3-5 days to conduct interviews and additional document review as needed. ​

· Post-onsite: Documentation of findings and completion of survey and post-survey paperwork and reports utilizing CA-DMHC audit tools and templates.

Rates:

$45 to $55/HR for about 2.5 months or more 100+-hours

******Must reside in California or surrounding states*****

Please email CV/Resume to KeithStewart@maximus.com if interested.