Clinical Practice Consultant

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

Job Summary

THIS IS A TELECOMMUTER ROLE FOR THE NEW MEXICO PLAN

BASIC FUNCTIONS: This position is a field-based quality position, responsible for supporting HCSC's Quality imperatives and value-based care models and relationships by collaboratively working with assigned Medical Practices or individual PCPs, the appropriate Medical Directors and clinic Directors and all medical and non-medical quality and other staff to improve key targeted HEDIS measures. This position participates in model/program development, clinical readiness assessments of entity and network management led joint operating committees, obtaining EMR access, implementing provider-based member outreach initiatives and provider supplemental data submissions, and retrieval of key medical records throughout the year. This role provides ongoing and annual evaluation of the effectiveness of the overall quality improvement program for the line of business assigned and is also responsible for creating and maintaining strong working relationships with the Care Coordination/Care Management teams at the value-based entity and internally with local network management and internal clinical operations teams to provide consultative support and ensure day to day operational needs are being met.

JOB REQUIREMENTS:

• Registered Nurse (RN) OR Physician's Assistant OR Nurse Practitioner with current, unrestricted license to practice in the state of New Mexico.

• 4 years' experience in health insurance, managed care or medical group experience.

• 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 30% including overnight stays.

#LI-Remote

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position.

We encourage people of all backgrounds and experiences to apply.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.