Provider Clinical Integration Program Advisor

Caresource Dayton , OH 45401

Posted 2 months ago

Role and Responsibility:

  • Responsible for researching, developing and integrating enterprise-wide provider clinical programs, initiatives, trainings, tools, and resources to connect providers with the goal of improving provider engagement, satisfaction, and clinical performance

  • Subject Matter Expert:

  • Provider requirements related to Market contracts, NCQA accreditation standards, and provider clinical performance

  • Provider clinical programs and initiatives

  • Provider behavioral health clinical programs

  • Provider involvement with population health programs

  • Clinical best practice recommendations

  • Collaborate and support Enterprise and Market teams to develop and integrate provider clinical staffing model, provider clinical engagement programs and initiatives, and provider and clinical engagement staff training and resource support

  • Collaborate with Analytic Teams and Market teams to interpret and apply data and analytics to implement best practices to inform and support market provider clinical programs and initiatives

  • Enhance effectiveness of health partner market teams through a variety of provider engagement and quality improvement techniques

  • Support Market teams to identify areas of opportunity to improve provider engagement and clinical outcomes

  • Assist in the development and integration of market provider engagement plans in collaboration with market leadership and other key stakeholders

  • Lead and participate in cross-functional workgroups / committees / forums to develop and integrate Market provider clinical programs and initiatives to improve provider clinical performance and satisfaction

  • Communicate in a clear, concise, and complete manner with upper management, peers, department staff, other disciplines within the organization, outside agencies and other entities to ensure prompt and proper exchange of information and resolution of issues

  • Perform any other job related instructions, as requested


Education / Experience:

  • Bachelor of Science in Nursing (BSN) or equivalent years of relevant clinical work experience is required

  • Master's Degree preferred

  • Minimum of three (3) years of healthcare experience is required

  • Minimum of three (3) years of experience in an acute or primary care setting is preferred

  • Previous experience working collaboratively with health care providers is required

Required Competencies / Knowledge /

  • Proficient in Microsoft Office Suite to include Outlook, Word, Excel and PowerPoint

  • Strong problem solving skills with attention to detail

  • Ability to develop, prioritize and accomplish goals

  • Strong ability to interpret and apply best practice, analysis and trending to inform programs and initiatives

  • Ability to engage teams in a positive, energetic manner

  • Familiarity with applicable Federal regulations, State regulations, and accreditation standards

  • Strong organizational and time management skills

  • Strong interpersonal skills and a high level of professionalism

  • Strong training/teaching skills

  • Ability to communicate effectively with a very diverse group of individuals

  • Ability to manage multiple programs and initiatives

  • Ability to work independently within a team environment

  • Ability to collaborate with other team members to optimize outcomes

  • Excellent written and verbal communication skills

  • Excellent listening and critical thinking skills

Licensure / Certification:

  • Current, unrestricted Registered Nurse (RN) licensure in state of practice is required

Working Conditions:

  • General office environment; required to sit/stand for long periods of time

  • Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer

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Provider Clinical Integration Program Advisor