Clinical Consultant I

Position Summary

The Clinical Consultant (CC) – Level I supports assigned payer clients by providing foundational clinical support across implementation, go-live, and post–go-live optimization of XSOLIS solutions. This role applies core Case Management (CM) and Utilization Management (UM) knowledge to support payer workflows, platform adoption, and identification of early performance and value opportunities. CC Level I supports clinical implementation and go-live activities, including assisting with prescriptive workflow execution, contributing to system build and configuration, and delivering education to super users and end users using adult learning principles. Following go-live, this role reinforces workflows, identifies adoption gaps, and supports interpretation of clinical and utilization data to promote compliance and early performance improvement.

Essential Duties & Responsibilities

• Clinical Implementation Support: Support assigned payer client implementations through prescriptive workflow execution and system build input. Participate in implementation meetings, milestone tracking, and readiness activities. Deliver product demonstrations and introduce standard analytical reporting as directed. Support training development and execution using established materials and workflows.
• Training, Adoption, and Execution: Deliver end-user and super-user education using adult learning principles. Conduct remote and onsite training as assigned and support early go-live adoption. Participate in focused workflow discussions and payer-specific operational reviews when requested. Reinforce standard utilization and authorization workflows aligned with payer requirements.
• Post-Implementation Optimization: Monitor standard KPIs (e.g., authorization timeliness, denial trends, exception rates, throughput indicators). Review dashboards and reports to identify adoption or utilization concerns. Support corrective actions aligned with established payer best practices. Escalate risks, barriers, or performance concerns through established channels.
• Client Partnership and Internal Collaboration: Partner with Client Delivery, Value Realization Partner (VRP), and Client Relationship Executive (CRE) teams to support payer implementation and early value realization. Participate in preparation sessions and support clinical components of Business Reviews.

Education

• Bachelor of Science in Nursing (BSN) required
• ACM or CCM preferred

Experience

• Experience working with payer organizations or payer-focused workflows required or strongly preferred
• Experience supporting clinical technology adoption and/or training initiatives

Qualifications

• Effective communication and facilitation skills
• Ability to interpret basic clinical and utilization data
• Adaptability to new technologies and workflows
• Professional, detail-oriented, and collaborative approach

Working Environment and Travel Requirements

• Work is typically in a normal office administrative environment involving minimal exposure to physical risks.
• Position requires little to moderate physical activity. Mostly sedentary work exerting up to 10 pounds of force occasionally or a negligible amount of force to lift, carry, push, pull, or otherwise move objects. Work involves sitting most of the time, but may involve walking or standing for brief periods of time. No significant stooping is usually required.
• This role requires travel to our home offices in TN for training.