Clinical Practice Liaison - Registered Nurse (RICHARDSON) - Clinical Liaison

Company: HCSC
Location: Richardson
Posted on: November 23, 2022

Job Description:

Clinical Practice Liaison - Registered Nurse (RICHARDSON)At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

Job Summary

POSITION IS FOR THE RICHARDSON OFFICE*

* THIS IS NOT A TELECOMMUTER ROLE, BUT A HYBRID/FLEX WORK SCHEDULE*

Responsibilities

This position serves as liaison between Network Management, the practices (health care providers / facilities) to analyze data and interpret information to assist in performing Program activities and meeting regulatory guidelines and desired outcomes. Performs additional duties in support of Retail IVR (Internal Validation Audit - Retail); directing and supporting clinical operations in physician practices, designing physician operational processes, analyzing and presenting outcomes, designing training, representing the company to external physicians and vendors, developing business relationships with physicians.

JOB REQUIREMENTS:

* Registered Nurse (RN) with current, valid license in the state of operations (TX).
* 3 years clinical experience.
* 4 years experience in a position which requires understanding/applications of managed care products, e.g. Marketplace/Retail, PPO, HMO.
* Knowledge of Care Management, Utilization Management and/or Case Management processes and practices.
* Project management experience including development, implementation and follow-up.
* Knowledge of HEDIS, State Department of Insurance and/or standards and accreditation processes of comparable regulatory bodies, i.e. JCAHO, URAC, NCQA).
* Organizational and technical skills for developing presentations, maintaining a library of presentations.
* Verbal and written communication skills for crafting presentation including developing corporate communications/ presentations.
* Experience effectively presenting presentations, training materials, etc.
* Ability to develop relationships with physicians and external vendors.
* PC proficiency to include Microsoft Applications with emphasis on developing PowerPoint presentations and other presentation formats.
* Initiative and independent working skills.

Preferred Job Qualifications:

* Training / Development and/or Supervisory/Management experience.
* Knowledge of physician office practices/processes including billing & coding.
* Experience leading nurses in auditing files for completeness in compliance with HEDIS, CMS and other regulations / guidelines.
* Knowledge of Risk Adjustment.
* CB

DICE 14

* CA

#LI-Hybrid

#LI-FW1

INAK

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position.

We encourage people of all backgrounds and experiences to apply. Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Keywords: HCSC, Richardson , Clinical Practice Liaison - Registered Nurse (RICHARDSON) - Clinical Liaison, Healthcare , Richardson, Texas