RN Clinical Consultant
3 weeks ago
Job Title: RN Clinical Consultant
Department: Health Services - Enhanced Care Management
About the Role:
As an RN Clinical Consultant, you play a pivotal role in ensuring the provision of high-quality care for enrollees within ECM Health Risk Assessments. You are entrusted with the critical task of assessing and determining the appropriate management of member care needs, either through the guidance of ECM Lead Care Managers or through your direct intervention and recommendation implementation in their Care Plans. Your expertise contributes significantly to the development of patient-centered care plans, fostering comprehensive approaches to healthcare that address acute conditions, chronic diseases, and medication management.
What You'll Do:
- Clinical Oversight and Consultation: Provide clinical oversight of ECM Health Risk Assessments, participating in the development and approval of patient-centered care plans, and actively consulting with Care Managers to review medical summaries, discharge orders, and appointment outcomes.
- Health Education and Outreach: Mentor and guide Lead Care Managers on how to offer health and preventive care education, particularly for acute health conditions and chronic disease management, while engaging with vulnerable populations through multidisciplinary meetings.
- Data-Driven Interventions: Utilize data to evaluate outcomes from targeted interventions for a designated patient cohort, assisting in the development and adjustment of care plans based on analysis and insights derived from this data.
- Program Expansion and Collaboration: Collaborate in expanding programming to address Social Determinants of Health (SDoH) and enhance connections to community-based organizations, dedicating focused time to program development and refinement.
- Multidisciplinary Collaboration: Lead and collaborate with a case management team and community health workers to ensure client/patient-centered care aligns with established Care Plans and health goals. Primary care providers and specialists will be involved in collaboration if needed.
- Regional Engagement and Coordination: Assist lead care managers with transitions of care ensuring seamless coordination with hospitals, behavioral health clinicians, primary care physicians, and other relevant providers to prevent readmissions and support transitions in care. Collaborate with ECM Specialist to address ADT alerts and post discharge coordination of care.
- Quality Improvement and Compliance: Engage in quality improvement efforts, including chart reviews, case conferences, and implementation of preventive care and engagement activities to continuously enhance the delivery of care.
- Valid Registered Nurse (RN) license in California
- Strong interpersonal skills and clinical problem-solving abilities.
- Basic computer skills, including email communication and data summarization in spreadsheets.
- Bachelor of Science in Nursing.
- Previous care management and supervisory experience.
- Bilingual proficiency in English and Spanish.
- Proficiency in Microsoft Office (Outlook, Teams, Word, Excel, Sharepoint)
- Proficiency in other applications like EZCap, MCG (Milliman Care Guidelines)
- Experience working with vulnerable populations, including individuals with a history of trauma, socioeconomic stress, homelessness, or substance use disorders
- Experience working with health plans
- Knowledge of managed care functions
- Proficiency in data analysis and utilization for performance tracking and measurement.
- Strong care planning experience
Our platform currently empowers over 12,000 physicians to provide care for over 1.3 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
- Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
- The total compensation target pay range for this role is between $40.00 - 50.00 per hour. The salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us to request an accommodation.
Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
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