Clinical Program Consultant (HBS)Primary Location: Houston, TX
Additional Locations: TX-Houston, TX-Sugar Land Apply
Clinical Program Consultants are key members of the Plan Sponsor Insights (PSI) business - a business focused on providing insights and solutions based on analytics to customers in the group commercial business. The work environment supports and thrives on out-of-the box thinking, creative talent and a consultative approach. Our team is highly valued by our internal partners as well as the customers we serve.
- Provide clinical consultation based on analysis and identification of key
drivers of results e.g. use data to identify clinical trends, evaluate performance results, monitor engagement and collaborate on opportunities for improvement
- Recommend clinical programs and services that align with the customer's
strategy and help drive short and long term results e.g. assisting with development of health strategies, tactics, policies and programs (which could include network management, clinical coverage, care management, and compliance policies for data and information) that improve overall population health and encourage efficient and effective delivery of benefits.
- Development and presentation of clinical content and recommendations in
customer facing meetings e.g. present findings and recommended actions to help improve performance and clinical outcomes, and work collaboratively to help track and resolve issues
- Act as a trusted clinical resource providing clinical program guidance
- Collaborate across the enterprise and with clinical operations and ACO to optimize collaboration, efficiency, and impact
- Provide input to the design of clinical solutions and workflows leveraging knowledge of workflow, policy, and procedures to help ensure teams can work successfully
- Stay current on, and share knowledge of, population health trends
- Registered Nurse (RN) License; Required
- Required Minimum of 5 years clinical experience (may be a combination of different sites of care practice including: hospital, clinic, and/or community health) with a strong understanding of clinical decision support platforms, EMR, and other technologies and data sources used within a healthcare delivery system
- 1+ years of Healthcare Consultation Experience working with External Constituents; Required
- 3+ years of experience with joint ventures, provider collaboration, or Accountable Care organizations; required
- 1+ years Leadership experience; required
- 1+ years of experience in, and knowledge of, the healthcare industry and market; Required
- 1+ years experience with medical management products, programs and services; Required
- Experience working with a Health Insurance Carrier, benefit plan design
- Strong problem-solving skills and attention to detail
- Strong clinical analytic skills and demonstrated conceptual thinking; required
- Excellent consultative, communication and presentation skills (ability to take complex content and facilitate understanding for the audience including preparing and presenting effective and compelling power point slides
- Ability to establish highly collaborative relationships within and outside the organization including at the executive level
- Experience with workflow development/process design
Must be able to be onsite fulltime at the customer location in Houston, TX and travel as needed ~0-10%. Flexibility to work at home 1x week.
If candidate is not currently WELCOA certified they will need to complete this certification once in the role.
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