Nurse Consultant - Remote in California
About The Position
As a Nurse Consultant at Gainwell, you will use your clinical expertise to help improve the health and well-being of the members our clients serve. In this role, you will work closely with clients, provide policy guidance, and support innovative solutions that improve healthcare outcomes. Your role in our mission is to analyze and apply state policy in a variety of situations, including client meetings and suspended claims reviews. You will serve as a subject matter expert on State policy and provide consultation and guidance to clients, respond to client referrals in a timely manner, recommend process improvements and approved modifications to support operational effectiveness and industry competitiveness, and identify potential opportunities for additional products or services and collaborate with the business development team as needed.
Requirements
- Active Registered Nurse (RN) license in the State of California.
- Must reside within 35 miles of the state capital.
- Minimum of two (2) years of professional nursing experience. A Master's Degree in Nursing may substitute for one (1) year of the required experience.
- Strong knowledge of nursing principles and practices, hospital operations, medical supplies, and their clinical applications.
- Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.
- Experience applying clinical knowledge, nursing judgment, and policy guidelines to medical claims review.
- Ability to participate in client meetings and serve as a trusted policy consultant.
- Strong communication, collaboration, and stakeholder engagement skills.
- Ability to develop and support business and consulting services initiatives.
Nice To Haves
- Wound and Ostomy training and/or certification preferred.
- Utilization Review experience is a plus.
Responsibilities
- Analyze and apply state policy in a variety of situations, including client meetings and suspended claims reviews.
- Serve as a subject matter expert on State policy and provide consultation and guidance to clients.
- Respond to client referrals in a timely manner.
- Recommend process improvements and approved modifications to support operational effectiveness and industry competitiveness.
- Identify potential opportunities for additional products or services and collaborate with the business development team as needed.
Benefits
- flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
- leadership and technical development academies
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
