Remote Clinical Practice Consultant

HCSC Group; United States; Remote; USD 71,000 - 150,000; Full time

Job summary

HCSC is seeking a field-based quality professional to support quality imperatives, value-based care models, and provider relationships by collaborating with medical practices, PCPs, Medical Directors, and Clinic Directors to improve HEDIS measures.

The role involves model and program development, clinical readiness assessments, EMR access, provider outreach, data submissions, and year-round evaluation of the overall quality improvement program for the assigned line of business.

Qualifications

• Registered Nurse (RN) or Physician Assistant or Nurse Practitioner with current, unrestricted license to practice in the state of operations.
• 4 years’ experience in health insurance, managed care or medical group insurance.
• Knowledge of federal and accreditation standards and regulations for the health insurance industry.
• Experience in designing clinical programs.
• Experience conducting presentations for member and/or provider training.
• Proven ability to work collaboratively with physicians.
• Ability to work independently.
• Effective communication and written skills and ability to communicate and influence internal and external customers at all levels of the organization.
• PC skills and familiarity with various software packages including spreadsheets and presentations.
• Ability to travel includes overnight stays.

Responsibilities

• Support quality imperatives and value-based care models with medical practices.
• Develop models and programs and perform clinical readiness assessments.
• Obtain EMR access and manage provider data submissions.
• Evaluate effectiveness of the quality improvement program for the assigned line of business.
• Build relationships with care coordination teams and internal Clinical Operations teams.

Skills

Clinical program design

Presentation skills

Collaboration with physicians

Independent work

Communication skills

PC skills

Travel ready

Job description

HCSC is seeking a field-based quality professional to support quality imperatives, value-based care models, and provider relationships by collaborating with medical practices, PCPs, Medical Directors, and Clinic Directors to improve HEDIS measures.

The role involves model and program development, clinical readiness assessments, EMR access, provider outreach, data submissions, and year-round evaluation of the overall quality improvement program for the assigned line of business.