Quality, RN

At Amwell, we’re transforming healthcare for all—powered by technology and inspired by people. Here, your ideas don’t just matter—they drive real change, improving lives on a global scale. We marry technology and innovation with clinical excellence to provide trusted solutions that solve the healthcare industry’s biggest pain points and are on a mission to enable greater access to more convenient, affordable, and effective care. We do this through our technology-enabled care platform that is designed to help our clients achieve their digital care ambitions – today and in the future. We offer programs spanning the full care continuum, including urgent, acute and specialty care, behavioral health, and services for the treatment of chronic conditions such as heart and cardiometabolic diseases. Programs are powered by Amwell as well as our growing partner network. For almost two decades, Amwell has proudly served some of the largest and most sophisticated healthcare organizations in the U.S. and worldwide. Our team is passionate about technology’s role in transforming care delivery and making it more equitable, accessible, efficient, cost-effective and navigable for all.

This position provides quality review and support to the AmWell Medical Group (AMG). The RN candidate will be employed by American Well providing review and support to the AmWell Medical Group Practice. The AmWell Medical Group is comprised of board-certified, credentialed, qualified physicians and other allied providers and built to provide online healthcare services for American Well’s Online Care clients. The AmWell Medical Group currently provides acute care services in approximately 44 states, with the expectation of expanding to providing other medical services (e.g., chronic care management, specialty care, behavioral health) in all 50 states in the future. Care is delivered utilizing American Well’s Online Care system. Online Care allows patients and consumers to connect with physicians immediately, whenever they have a health need, from their homes or offices. The innovation uses advanced Web-based technologies and telephony to remove traditional barriers to healthcare access, including insurance coverage, geography, mobility, and time constraints.

Participate in monthly Ongoing Professional Provider Evaluation (OPPE)- in depth provider case reviews Identify provider trends, deficits in clinical and documentation standards Participation in Provider coaching/training Participate in monthly client meeting to understand and support client expectations Initiation and management of Prior Authorizations Participation in workflow design and QA improvements Participation in risk management planning Participation in ongoing policy and procedure design and editing- including, but not limited to clinical matters, intake, emergency preparation, referral planning and documentation Participation in regulatory assessment and compliance planning Interface with providers as needed Provide clinical support to other departments as needed to support organizational initiatives Participation in department and committee meetings Participation in the development of a process that measures outcomes Participation in the quality management program, including investigation of red flag cases and adverse events Participate in root cause analysis