Resp & Qualifications
Although this position is listed as "remote" candidates are preferred to live in the MD, DC, VA area in order to travel into the offices / clients at least 30% of the time.
PURPOSE:
The Clinical Advisor's role is multifaceted from data analytics, client facing presentations, and solutions optimization. The Clinical Advisor will extract clinical and relevant data to educate clients, brokers, consultants, and internal stakeholders, showcasing the value of the organization's approach to managing care delivery. The Clinical Advisor will synthesize data and make individualized recommendations related to population health with a goal of improving outcomes and driving down cost in populations. The Clinical Advisor serves as key subject matter expert and strategic partner for the Sales team and will regularly attend onsite and virtual client meetings to review health outcomes and cost information.
ESSENTIAL FUNCTIONS:
- Analyzes population health data as well as clinical and financial trends, for existing and prospect customer accounts. Develops business case studies and next generation reports to demonstrate the value of care management and wellness approaches. Makes strategic recommendations for key accounts and their consultants/brokers to retain and grow business.
- Delivers presentations and demonstrates to external clients, customers and prospects the value proposition and return on investment of assigned solutions.
- Consults with key stakeholders regarding cost containment and quality improvement for their employee populations.
- Identifies gaps in care and make referrals to appropriate programs.
- As a clinical subject matter expert, reviews and analyzes member data to show value of care management programs.
- Collaborates with internal teams including wellness, pharmacy, and care management. Creates and executes upon a sales strategy for the assigned solutions to help customers meet their clinical goals.
- Present and demonstrate to external clients, customers and prospects the value proposition and return on investment of assigned solutions in a consultative approach. Consult about how to best control cost and improve quality for their employee populations.
- Using clinical knowledge, review and analyze member data to show the value of the organizations care management efforts; identify gaps in care and make referrals to appropriate programs.
QUALIFICATIONS:
Education Level: Bachelor's Degree in Nursing, Pharmacy, Psychology, Behavioral Health, Social Work or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
Licenses/Certifications:
- RN - Registered Nurse - State Licensure And/or Compact State Licensure.
Experience:
- 4 years experience working in a clinical setting.
- 2 years demonstrated experience with healthcare data analysis.
Preferred Qualifications:
- Graduate degree such as MSN, MBA, MPH.
- Knowledge of health plan sales or account management.
- Experience working in a health plan environment in a business role.
Knowledge, Skills and Abilities (KSAs)
- Ability to present onsite and virtually to both small and large audiences.
- An in-depth knowledge of current and emerging trends in care management.
- Ability to work closely with and influence people at all levels, including C-suite executives, vice presidents, directors, managers, and associates.
- Critical thinking and judgment with the ability to connect the dots, put the story together and then deliver to the client in a professional manner.
- Demonstrated ability to analyze and interpret data.
- Ability to lead/coordinate projects and function as a resource to other CareFirst departments.
- Ability to communicate effectively, both verbally and in writing.
- Ability to present and communicate in group settings in a professional manner.
- Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for extended periods of time. Must be able to meet established deadlines and manage multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range: $76,248 - $151,437 (salaries are based on years of experience, education & internal equity)
Travel Requirements:
Estimated Amount: 30% travel within Maryland, DC and Virginia.Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Department
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
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