Job Description
Vatica Health and Cozeva bring together clinical expertise and technology to support risk adjustment, quality, and value-based care. Our teams help providers and health plans use clinical information to improve documentation and identify care gaps.
As a Clinical Nurse Consultant I, you will use your clinical judgment to turn information from medical records and payer data into clear findings that help providers accurately document member conditions and identify gaps in care. You will work directly with providers and practice teams, combining detailed chart review with relationship building and technology support.
This clinical production role requires independent workload management and consistent performance against chart completion and quality standards. Work is primarily remote, with travel to provider offices for training as needed.
Responsibilities
Review and synthesize information from electronic medical records (EMRs), payer files, and other clinical sources to build an accurate view of each member’s documented clinical status.
Evaluate clinical evidence for active conditions relevant to the applicable risk adjustment model and present findings to support provider condition validation decisions.
Reconcile conflicting or incomplete clinical information.
Identify open quality-of-care gaps and communicate findings to practice teams for follow-up.
Complete chart reviews within established productivity targets and deadlines while meeting quality assurance standards for accuracy and compliance.
Build effective relationships with providers and office staff and follow up on outstanding items to meet deadlines.
Train and support providers and practice staff on company technology and workflows, including onsite training as needed.
Share clinical knowledge and best practices with colleagues to support consistent, accurate chart reviews.
Active, unrestricted Registered Nurse (RN) license.
Minimum of three years of recent RN clinical experience assessing complex patient conditions and interpreting clinical documentation.
Demonstrated clinical judgment in evaluating conflicting information and identifying documentation gaps.
Clear, professional communication of clinical findings and documentation questions to providers and practice staff.
Proficiency with EMRs and web-based applications, including navigating multiple systems and learning new technology independently.
Demonstrated success managing detailed clinical work against productivity, accuracy, and deadline expectations.
Effective independent workload management and collaboration in a remote team environment.
Ability to travel occasionally to local provider offices, with access to a personal vehicle or other reliable transportation.
Preferred Qualifications
- RN experience in acute care, critical care, or an emergency department.
- Clinical Documentation Improvement (CDI) experience strongly preferred.
- Knowledge of diagnosis coding, billing concepts, quality measures, and risk adjustment models.
WORKING AT VATICA HEALTH ADVANTAGES
Prosperity
- Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
- Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
- 401k plans– we want to empower you to prepare for your future
- Room for growth and advancement- we love our employees and want to develop within
Good Health
- Comprehensive Medical, Dental, and Vision insurance plans
- Tax-free Dependent Care Account
- Life insurance, short-term, and long-term disability
Happiness
- Excellent PTO policy (everyone deserves a vacation now and then)
- Great work-life balance environment- We believe family comes first!
- Strong supportive teams- There is always a helping hand when you need it
Compensation: $33–$47 per hour, equivalent to $68,640–$97,760 annually based on a 40-hour workweek. The starting rate within this range will reflect relevant experience, certifications, and geographic location.
