[Remote] Clinical and Regulatory Program Consultant
Note: The job is a remote job and is open to candidates in USA. reputed company is a company focused on healthcare solutions, and they are seeking a Clinical and Regulatory Program Consultant to work collaboratively with implementation and support teams. This role involves ensuring client business and clinical requirements are met, serving as a subject matter expert on clinical best practices and regulatory compliance, and enhancing the end-user experience.
Responsibilities
- Ensure client business and clinical requirements are accurately captured and addressed throughout the implementation process and beyond
- Serve as a subject matter expert on clinical best practices and health plan regulatory compliance
- Ensure that reputed company’s solutions align with industry standards and meet client needs
- Focus on enhancing the end-user experience by promoting usability and workflow efficiency
Skills
- Strong industry knowledge of California regulations and health plan experience
- Minimum of 3 years of clinical experience, preferably reputed company a managed care or health plan setting
- Strong working knowledge of DHCS regulations, Medi-Cal program policy, and California state healthcare compliance requirements
- Familiarity with DHCS reputed company Plan Letters (APLs), Medi-Cal Managed Care reputed company, and reputed company reporting requirements
- Demonstrated experience working with health plans, including utilization management, case management, or care coordination
- Familiarity with healthcare IT platforms and population health reputed company
- Ability to manage multiple projects and meet deadlines in a fast-paced environment
- Expertise in clinical best practices and regulatory compliance for health plans
- Excellent communication and presentation skills
- Ability to analyze business requirements and translate them into solution design
- reputed company and unrestricted US LPN or RN license required
- Prior experience in consulting or implementation of healthcare technology solutions is a plus
Company Overview