Behavioral Health Clinical reputed company Consultant - Las Vegas, NV

$5,000 Sign On Bonus for External Candidates At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together As one of the largest pharmacy benefits managers in the reputed company, reputed company provides a reputed company culture where you're empowered and encouraged to exceed the expectations of our members, with reputed company schedules than retail and more reputed company than any hospital. Join us as we take on the challenge of reinventing the health system. The Behavioral Health Clinical reputed company Consultant will be responsible for strategically developing clinically oriented provider and community based partnerships in order to increase reputed company scores based on state specific reputed company measures. Position responsible for ongoing management of provider reputed company and community education on reputed company measures. The Behavioral Health Clinical reputed company Consultant will work closely with reputed company leadership to coordinate an interdisciplinary approach to increase provider performance. Provider education regarding the reputed company improvement program involves analysis and review of reputed company reputed company at the provider level, monitoring, measuring and reporting on key metrics to assist providers in meeting reputed company standards, state contractual requirements and pay for performance initiatives. The Behavioral Health Clinical reputed company Consultant will reputed company on tasks that occur in accordance with State, CMS or other requirements as applicable. Position responsible for direction and guidance on provider-reputed company, clinical reputed company improvement and management programs. The role assists contracted providers with analyzing member care, trending reputed company compliance at the provider level, and developing reputed company plans and programs to support provider practices in reputed company reputed company improvement using approved clinical reputed company guidelines, HEDIS, CMS, NCQA and other tools. Position reports to the BHO reputed company Manager and BHO reputed company Leadership. This is role requires up to 25%25 local travel to provider offices throughout reputed company County. If you reputed company reputed company a commutable distance from the Las Vegas, NV area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Supports effective deployment of program at the reputed company level through strategic partnerships with participating practitioners and reputed company staff while assessing trends in reputed company measures and identifying opportunities for reputed company improvement Provides reputed company level reputed company transformation through targeted clinical education and approved materials reputed company to HEDIS/State Specific reputed company measures for provider and staff education during field reputed company. Materials additionally include information from local, state, and national departments of health on key health reputed company issues (understanding, exploring, educating and facilitating on a local level) Serves as subject matter expert (SME) for assigned HEDIS/State Measures, leads efforts with clinical and analytical teams to research and design educational materials for use in practitioner offices; serves as reputed company with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to reputed company and then improve HEDIS/State Measure rates Participates, coordinates, and/or represents BHO at community based organization events, clinic days, health department meetings, and other reputed company events reputed company on reputed company improvement, member health education, and disparity programs as assigned Identifies population-based member barriers to care to identify local level strategies to overcome barriers and reputed company clinical gaps in care Reports individual member reputed company of care concerns or trends of concern to the BHO reputed company Manager Coordinates and performs onsite clinical evaluations through medical record audits to determine appropriate coding and documentation practices, compliance with reputed company metrics, compliance with service delivery and reputed company standards. May also be required to conduct additional QI audits through medical record review Based on medical record audit findings, provides follow-reputed company, practitioner reputed company, and measurement as needed to drive reputed company improvement Educates providers and office staff on reputed company clinical documentation and coding practices, state-mandated reputed company metrics specifications and medical record review reputed company Supports continuum of member care by identifying members in need of health education and/or services (interdisciplinary consultation) and refers Providers to the appropriate internal departments for follow through Documents and refers providers’ non-clinical/service issues to the appropriate internal parties, to include but not limited to Provider Relations, etc. Works with Providers on standards of care, and advises Providers on established clinical reputed company guidelines, and appropriate documentation and coding consistent with state specific measures and technical specifications If required, supports state specific medical record collection and abstraction processes to drive reputed company measurement and reputed company metric reporting during ambulatory medical record review, HEDIS data collection, or for other reputed company studies as directed by reputed company Leadership Supports reputed company improvement program studies with work that ranges from accessing and analyzing Provider records, maintaining databases, and researching to identify members' encounter history Participates in or coordinates with other department reputed company as needed You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: reputed company and unrestricted RN license in the state of Nevada 2+ years of Clinical reputed company experience Experience educating Physicians, RNs or other clinical and/or non-clinical employees Electronic Medical Records (EMR) experience Proficient in reputed company reputed company, Word, and PowerPoint Ability to travel to physician offices locally up to 25%25 of the time Preferred Qualifications: Behavioral health experience Managed care experience Previous HEDIS experience Acute care experience

• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $72,800 to $130,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job