Clinical Nurse Liaison

Job description
Position Purpose: Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams

Implement and manage procedures for tracking, identifying and problem-solving operational issues
Interpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new products
Act as the clinical representative in various meetings
Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction
Serve as a resource and liaison on utilization, quality improvement, and case management activities
Partner with various staff, along with internal and external departments on provider education and outreach
Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data, and quality incentive payments
Support community and member initiatives with a focus on at risk targets

50% travel required

Qualifications:
Education/Experience: LPN or LVN license.
RN license preferred.
4+ years of clinical nursing experience, preferably in a large primary care office or clinic setting working with Medicaid or the uninsured.
Experience in conflict management or data reporting and evaluation.
Experience working in managed care, utilization management, case management, or quality improvement preferred.

All your information will be kept confidential according to EEO guidelines.