Healthcare Business Development Consultant

3 days ago


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

We are seeking a seasoned Clinical Administrative RN Consultant for a long-term temporary position with a leading managed care company based in Tampa, FL. This role involves developing and implementing market business plans to motivate providers to improve HCC/Suspect Medical Conditions metrics.

About the Role

This Clinical Administrative RN Consultant will serve as a Subject Matter Expert (SME) for all related activities within their assigned markets, working closely with quality field operations and Regional/Market operations teams. The ideal candidate will have a strong understanding of CMS HCC Model and Guidelines, as well as ICD-10 Guidelines.

Responsibilities include:

  • Developing solution-based initiatives to analyze and evaluate provider group structure and characteristics, provider group/provider office operations, and personnel to identify effective approaches and strategies.
  • Analyzing Provider and Group performance to determine areas of focus or improvement opportunities.
  • Providing analytical interpretation of conditions reporting, including Patient Care Opportunity Report, Insight Reporting Suite, and Practice Assist.
  • Assisting in developing training and analytical materials.
  • Overseeing coding and documentation accuracy training and education delivery.
  • Leading Weekly, Monthly, Bi-monthly, Quarterly, and/or Annual Business Review meetings.

The successful candidate will have a Bachelor's Degree in Nursing, current RN license in good standing, and at least 1 year of ICD-9, ICD-10 coding experience. Additionally, they will possess CPC certification or proof that certification has been obtained within 9 months from the American Academy of Professional Coders.

The salary for this position is estimated to be around $80,000 - $100,000 per year, depending on experience and qualifications. The role also offers a competitive benefits package and opportunities for professional growth and development.



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