Clinical Operations Advisor

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

United States, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

keywords: summary,job description,work environment,management,leadership,reporting,performance,other duties,education & experience,knowledge,problem solving,communication,skills


Competitive Compensation and Benefits Package

Overview: <br /><br />Performs clinical executive support tasks which may be highly confidential and sensitive in nature utilizing extensive independent judgment. Interacts with executive leadership and serves as internal and external liaison between the Senior Health Services, Vice President, Care Delivery, FFS, and direct reports, staff, other professionals in the community, and BCBSM executive offices, using tact, discretion, and prudence. Responsible for managing clinical operational programs and projects that support member engagement, cost of care reductions, Stars, Risk Adjustment including work that involves coordinating day-to-day executive deliverables, communications, timelines, and process development. Manage and implement clinical department activities and communications, internal and external. Perform functions, including organizing, coordinating, researching, compiling, exchanging, and analyzing information for Senior Health Services, Vice President, Care Delivery, FFS, and department.<br /><br /><br /><strong>WORKING CONDITIONS:<br /><br /></strong> <p>Work is performed in an office setting with no unusual hazards. Travel may be required. Ability to work outside of normal business hours.</p>
Responsibilities: <br /> <ul> <li>Ensure the preparedness of the Senior Health Services, Vice President, Care Delivery, FFS by activities such as analyzing data, developing materials and communications, and recommending appropriate action.</li> <li>Work to ensure that projects assigned or delegated to the direct reports of Senior Health Services, Vice President, Care Delivery, FFS are executed and completed.</li> <li>Work with enterprise-wide senior management, directors, and managers to successfully complete assignments.</li> <li>Research, compile, assimilate and prepare documents, presentations, and meeting materials.</li> <li>Brief Senior Health Services, Vice President, Care Delivery, FFS regarding contents of documents.</li> <li>Coordinate and facilitate Senior Health Services, Vice President, Care Delivery, FFS calendar to ensure responsibilities are fulfilled with the greatest degree of efficiency and success.</li> <li>Coordinate and research special clinical projects and assignments.</li> <li>Lead/make significant contributions, and/or provide leadership to clinical initiatives to ensure Senior Health Services, Vice President, Care Delivery, FFS expectations are met and/or intentions are fulfilled.</li> <li>Oversee initiative development and projects by effectively leading teams from start to finish.</li> <li>Ability to assign and oversee tasks based on the skills of each team member.</li> <li>Ability to solve a variety of problems throughout all stages of the project to ensure timely completion.</li> <li>Effectively and competently lead a team; recognize when help is needed.</li> <li>Ability to prioritize multiple initiative development and deadlines.</li> <li>Provide detailed, succinct updates as needed.</li> <li>Lead team towards a common purpose with enthusiasm and motivation throughout the entire project.</li> <li>Assists direct reports and staff in focusing on priority clinical projects, monitoring progress for timely completion/submission, and provide reminders of approaching deadlines.</li> <li>Coordinates and prioritizes office activities. Follow up on information and requests. Updates executive on issues as necessary.</li> <li>Develops, compiles, and maintains various filing systems and informational databases and generates reports as requested or as scheduled.</li> <li>Work with minimum supervision and exercises sufficient discretion and independent judgment.</li> <li>Manage multiple priorities and deadlines.</li> <li>Maintain confidentiality.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION OR EQUIVALENT EXPERIENCE:</strong></p> <ul> <li>Registered Nurse or equivalent healthcare degree Continuous learning, as defined by the company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <br /> <p><strong>EXPERIENCE:<br /></strong></p> <ul> <li>5 years of health care experience.&nbsp;</li> <li>Managed Care and Medicare experience preferred.&nbsp;</li> <li>Seven or more years of proven ability to interact with all levels of management is required.</li> <li>Five years experience with demonstrated technical abilities that provides the necessary skills and abilities. &nbsp;</li> <li>Bilingual skills preferred.</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Excellent verbal and written communication skills with the ability to compose correspondence and other documents.</li> <li>Knowledge of organization, company, and departmental policies and procedures.</li> <li>Demonstrated ability to work with (and understand the rank of) enterprise executives, senior management, and external contacts.</li> <li>Ability to manage multiple priorities, establish workflows, and meet necessary deadlines.</li> <li>Ability to effectively exchange information clearly and concisely, and present ideas, report facts and other information, respond to questions, and employ active listening techniques.&nbsp;&nbsp;&nbsp;</li> <li>Ability to apply the principles of independent logical, analytical thinking to define problems, collect data, establish facts and draw valid conclusions.</li> <li>Ability to comprehend the consequences of various problem situations and to refer them for appropriate decision-making.</li> <li>Ability to establish rapport and maintain effective working relationships with both internal and external customers and service providers.</li> <li>Knowledge of the workers' compensation insurance industry and the independent agency system.</li> <li>Ability to interact with others to build consensus and get decisions implemented.</li> <li>Ability and proficiency in the use of computers and company standard software specific to position, including spreadsheets and the Internet.</li> <li>Must exhibit efficiency, collaboration, openness, diplomacy, tact, discretion, and judgment.</li> <li>Ability to maintain confidentiality.&nbsp;</li> <li>Ability to perform other assignments at locations outside the office.</li> <li>Excellent organizational skills.</li> </ul>