Clinical Health Consultant

4 days ago


Kansas City, Missouri, United States ALLMED STAFFING INC Full time
Job Overview

Clinical Administrative RN Consultant needed for a long-term temp position with a leading managed care company. The ideal candidate should reside in Tampa, FL, and be willing to travel as required.

Key Responsibilities:

  • Develop and implement market business plans to enhance HCC/Suspect Medical Conditions metrics.
  • Analyze conditions reporting data from Patient Care Opportunity Report, Insight Reporting Suite, and Practice Assist to inform provider groups.
  • Serve as a Subject Matter Expert (SME) for related activities within assigned markets, encompassing quality field operations and regional/market operations.
  • Contribute to the development of training and analytical materials.
  • Oversee coding and documentation accuracy training and education delivery.
  • Lead regular business review meetings.
  • Analyze provider group structure and characteristics to identify effective approaches and strategies.
  • Evaluate provider and group performance to determine areas of focus or improvement opportunities.

Requirements:

  • Bachelor's Degree in Nursing required; current RN license in good standing.
  • CPC certification or proof of obtaining within 9 months from the American Academy of Professional Coders.
  • 1+ years of ICD-9, ICD10 coding experience.
  • 5+ years of associated business experience in the healthcare industry.
  • Knowledge of CMS HCC Model and Guidelines along with ICD 10 Guidelines.
  • Strong understanding of the Medicare market, products, and competitors.
  • Able and willing to travel as determined by business needs.

Compensation and Benefits:

The estimated salary for this role is $120,000 - $150,000 per annum, commensurate with experience. Additionally, you will have access to our comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.


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