Clinical ValueBased Consultant- RN Job Northern Kentucky USA,Healthcare

Location: Northern

Job Type:

Regular

Scheduled

Hours:

Job Summary:

Reports to the Manager of Value Based Performance, the Clinical Value-Based Consultant (CVBC) will work directly with Value Based Performance (VBP) manager and director on all set organizational quality and utilization goals as it relates to value-based contracts. The VBC is responsible for working collaboratively with stakeholders at all levels of the organization including: executive leadership, provider practices, Clinical Transformation departments and other external organization leadership.

The Value Based Consultant is responsible for managing assigned payor contracts by tracking, trending, analyzing, and implementing interventions based on payor and internal data. The VBC may also outreach directly to SEP providers, patients and/or caregivers regarding identified care opportunities. The VBC serves as a liaison between the healthcare system and payor representatives, working collaboratively to support the organization’s success with value-based contracts.

The VBC will lead and/or contribute to organizational projects that require value-based input.

The Clinical Value-Based Consultant works collaboratively and uses their clinical skills and judgement for the following:

Evaluate processes for clinical appropriateness while ensuring they meet value-based contract requirements.
Referring patients for additional resources such as: care coordination, pharmacy, and/or social work.
Serves as a clinical resource to non-clinical associates. They will provide clinical guidance as needed.
Assists with orientation and onboarding in the Value Based Performance department.

Job Description:

Clinical Value Based Consultant Tier I

Job Code:

11170

Benefits:

Remote Work Eligible after training (Must live within 1 hour from Erlanger KY to be considered) equipment provided
No Nights, Holidays, or Weekends.
Paid Time Off
Medical, Dental, and Vision
403b with Match
Opportunity for Career Growth

Education:

Minimum:
Associate's degree with RN Licensure

Years Of

Experience:

Minimum: 2-5 years in a healthcare delivery system, including experience with direct physician and patient contact. Previous experience in Population Health, Quality, or Clinical Management preferred.

Licenses And

Certifications:

Active, unencumbered multistate (compact) RN nursing license issued by a Nurse Licensure Compact (NLC) state, specifically Kentucky, Indiana or Ohio.
Must have a valid driver’s license for travel between office sites (if applicable)

Duties And Responsibilities:

Responsible for collecting, aggregating and analyzing data related to assigned value base contracts and performance.
-Analyze contract data to identify trends and changes. Prepare and present verbal and formal updates regarding barriers.
-Support appropriate stakeholders with data needs as it relates to assigned value-based contracts.
-Implements interventions as deemed appropriate based on findings in data reviewed.
Partners with and facilitates communication with leaders, stakeholders and frontline staff to develop, implement and maintain a successful partnership as it relates to assigned value-based contract metrics.
Examine current organizational workflows and data to advise appropriate stakeholders on opportunities for improvement as it relates to value-based contract expectations and incentives.
-Attention to detail, organizational skills, effective communication, flexibility and adaptability to change, and a great attitude, are critical.
Provides leadership and coordination support to any area in the organization that requires information or education related to value-based contracts and opportunities.
-May develop, edit and share reports and/or presentations intended to inform stakeholders.
Supports and/or leads organizational or…