Clinical Advisor, RN (Remote)

CareFirst BlueCross BlueShield

Resp & Qualifications

CANDIDATES MUST BE LOCAL TO MD, DC, VA

PURPOSE:

The Clinical Advisor's role is multifaceted, involving data analytics, client facing presentations, and solutions optimization. The Clinical Advisor will extract relevant clinical data and 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 data trends to 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 clinical story and value position of the CareFirst clinical solutions.
• Consults with key stakeholders regarding cost containment and quality improvement for their employee populations.
• Identifies gaps in care and makes 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 wellbeing, pharmacy, medical, sales, data, and care management. Creates and executes upon a sales strategy for the assigned solutions to help customers meet their clinical goals.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Nursing, Pharmacy, Psychology, Behavioral Health, Social Work or related field. In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience:

• 4 years experience working in a clinical setting.
• 2 years demonstrated experience with healthcare data analysis.

Licenses/Certifications Required:

• RN - Registered Nurse - State Licensure And/or Compact State Licensure.

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, maneuver fluently in Excel, Microsoft, Word, and Power Point.
• Ability to lead/coordinate projects and function as a resource to other CareFirst departments.
• Ability to communicate effectively, both verbally and written.
• Ability to present and communicate in group settings in a professional manner.

Salary Range: $76,248 - $151,437


Travel Requirements
Estimate Amount: 50% 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 responsibilities 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

Workplace Wellness DC

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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