Clinical Operations Coordinator

22 hours ago


Chicago, Illinois, United States w3r Consulting Full time
Job Overview: We are looking for a talented Clinical Operations Coordinator to join our team at w3r Consulting. As a Clinical Operations Coordinator, you will play a critical role in ensuring the smooth operation of our clinical programs. Your primary responsibilities will include monitoring utilization management activities of medical groups and IPAs, measuring adherence to HMO UM/QR standards, and communicating outcomes to medical groups and HMO management.

Key Responsibilities:
  • Evaluate the need for, design, and implement corrective action plans for deficient medical groups and IPAs
  • Coordinate with Corporate Audit department regarding corporate site audits and related corrective action plans
  • Prepare cost analyses and make recommendations to the Medical Director(s) on extra contractual benefit requests
  • Provide necessary administrative support to assist medical groups and IPAs with unusual benefit requests, transplant cases, benefit terminations, IBMP cases, and other special issues

Requirements:
- Registered Nurse (RN) with unrestricted license
- 3 years clinical experience with 2 years experience in utilization review, quality assurance, or statistical research
- Clinical knowledge, knowledge of the UM/QR process, and knowledge of managed care principles
- Analytical, verbal, and written communications skills
- Current Illinois driver's license
- Able and willing to travel, including overnight stays

What We Offer:
- Salary range: $90,000 - $120,000 per year
- Opportunities for professional growth and development
- Collaborative and dynamic work environment


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