Provider Clinical Liaison (Nurse Auditor)

Elevance Health; California (MO); Hybrid; USD 59,291 - 106,722; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase options

401(k) contribution

Job summary

A leading health services company is looking for a Provider Clinical Liaison in California. The role involves building relationships with healthcare providers to support patient-centered care initiatives. Candidates should have a BA/BS in Nursing and a valid RN license, along with at least 5 years of medical management experience. The position offers a salary range of $43.04/hr to $77.47/hr and comes with a comprehensive benefits package, including stock options and a 401(k).

Qualifications

• Minimum 5 years of medical management experience.
• Current unrestricted RN license required.

Responsibilities

• Act as the clinical point of contact for providers.
• Conduct clinical review meetings with physician office staff.
• Collaborate on program review and design enhancements.

Skills

Medical management experience

Proficiency in Microsoft Office

Experience with Electronic Health Records (EHR)

Knowledge of medical terminology

Education

BA/BS in Nursing

RN license

Job description

Location

Selected candidate must reside in the State of California.

Field

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands‑on engagement.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Provider Clinical Liaison

The Provider Clinical Liaison is responsible for Patient Centered Care (PC2) program implementation focusing on partnering and building relationships with providers and their office staff to support their understanding of disease and case management.

How you will make an impact

• Serves as the clinical point of contact for providers and primary care practices for orientation, ongoing training, and support for the practice's clinical coordination and care management team regarding company clinical programs and case management concepts.
• Conducts clinical review meetings with physician office staff and internal staff.
• Works in collaboration with the PC2 team on program review, evaluation and program design enhancements.
• Serves as the subject matter expert for primary care practices on all Care Management programs for all lines of business and care management programs (i.e., CM, DM, Senior, Nurse Line).
• Partners with case/disease management departments to facilitate clinical processes between the company and provider offices.
• Serves as a liaison with state/region provider contracting account managers and other associates.

Minimum Requirements

• BA/BS in Nursing and minimum of 5 years of medical management experience; or any combination of education and experience providing an equivalent background.
• Current unrestricted RN license required.

Preferred Skills, Capabilities and Experiences

• MS or advanced degree preferred.
• 1 year experience in quality and/or risk management.
• Experience conducting mandated facility site reviews and medical record audits highly preferred.
• Highly proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint), experienced with Electronic Health Records (EHR), and knowledgeable in medical terminology.

Salary

Salary range: $43.04/hr to $77.47/hr.

Benefits

Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase options, and 401(k) contribution.

Hybrid Work Requirements

Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for onsite time will be discussed as part of the hiring process.

COVID-19 Vaccination Requirement

All new candidates in patient/member-facing roles are required to be vaccinated against COVID-19 and Influenza. If not vaccinated, the offer will be rescinded unless an acceptable explanation is provided.

Equal Employment Opportunity Statement

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact [e-mail] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.