Sr Clinical Consultant

About the role

The Senior Clinical Consultant will perform in various roles focusing on clinical opportunities for members, providers, and employers. The position serves as the liaison for all clinical service issues, assisting in coordinating, producing, and presenting high-quality presentations for performance reviews.

Responsibilities

• Analyzes data and metrics from a variety of departments and sources to effectively communicate with groups clinically related material related to their plan’s performance.
• Works collaboratively with the team to develop the performance review presentations.
• On an ongoing basis reviews data related to performance metrics and alerts on any issues or concerns related to clinical performance.
• Identifies and coordinates clinical strategies to assist with addressing any plan performance concerns.
• Serves as a resource for issues related to clinical content on the portal.
• Provides daily support to resolution of escalated issues or questions.
• Collaborates with internal departments to research and provide a response.
• Implements training on company resources and alternative paths for problem resolution.
• Redirects to other Point32Health key points of contact.
• Account Clinical Performance Guarantees:
• Works in collaboration with other departments to develop clinical performance guarantees.
• Ensures processes are in place to track clinical performance guarantees related to applicable accounts and intervenes as needed if guarantees are not being met.
• Provider Relationships:
• Jointly works with the Medical Director to establish provider relationships as needed.
• Aids in the development and implementation of provider collaborations and oversees coordination requiring other departments within the organization.
• Participates in and assists with provider meetings.
• Collaborates with Provider Performance, Provider Contracting, and Quality teams as necessary.

Qualifications

• Current Registered Nurse state license.
• Education: Associate's degree in nursing or BSN preferred; Master’s degree; MPH desirable.
• Experience: 5 – 7 years of clinical nursing experience preferred; patient education experience desirable.
• Skills: Proficiency in a second language is also highly desirable; work site wellness consultation desirable; excellent verbal and written communication, active listening skills, and high-level presentation skills; ability to analyze and comprehend complex data; ability to address multiple complex issues throughout the workday in a flexible professional manner; initiative, sound judgment, and the ability to work under pressure in a constantly changing environment; appropriate judgment as necessary and raising issues to the appropriate level; strong clinical and critical thinking abilities; ability to synthesize timely updates based on Point32Health Business needs and current events in the community; excellent web and business writing skills as well as project or program management experience; strong computer skills required including proficiency in Excel, Word, PowerPoint, and Visio; ability to perform job functions with autonomy; influencing others and ability to quickly build partnerships particularly those outside of direct reporting relationships; ability to synthesize and present complex information; self-directing, politically astute and having outstanding interpersonal, teaching, decision-making and presentation skills; commitment to excellence in customer service.

Salary Range

$109,730.00 - $164,595.00