Oncology Practice Enablement Clinican
Carelon Medical Benefits Management
Location: The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations and might have some onsite travel required.
Schedule: This position is set to start mid January. The ongoing scheduled will be Monday-Friday 8-5.
A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
The Oncology Practice Enablement Clinician is responsible and accountable for partnering and building critical relationships with oncology practices (providers and administrative staff) to drive success with key strategic solutions that involve practice collaboration and enablement to improve member care quality and value within the development of a Value Based Network (VBN) for the Total Cost of Care (TCOC) in oncology care.
How you will make an impact:
- Independently manages relationships with provider practices by providing orientation, on-going training, practice enablement, transformation, and support.
- Onboards practice to VBN program.
- Provides ongoing support through Practice Support break out meetings to meet practice needs.
- Partners with PTC to implement and monitor practice transformation efforts.
- Conducts regular clinically-focused, cross-functional strategic committee meetings (JOCs), with focus on assessment and evaluation of practice specific quality and key performance metrics to identify opportunities for improvement.
- Schedules and hosts regularly scheduled meeting (JOCs) as well as break out practice support meetings as needed based on practice needs.
- Conducts "deep dives" into specific quality measure and hosts review meetings as needed with practice.
- Oversee and partners with PTCs to perform data analysis to identify positive and/or negative trends in their quality data.
- Review areas of improvement within JOCs and/or as outreach to practice as needed.
- Serve as the subject matter expert for provider practices for all company programs for all lines of business and other care management initiatives to include TCoC VBN Oncology program.
- Stays up to date on all VBN program related communications and disseminates to practice.
- Educates practice to all organization solutions to improve quality and cost of care.
- Maintain understanding of oncology and palliative care clinical domain and industry changes.
- Hosts internal Provider Enablement team education session once annually.
- Partner with organization teams to host program specific meetings and educate practices to various solutions that support practice transformation.
- Serves as a liaison with state and regional provider contracting account managers and third-party contracting agent for VBN program.
- Executes GTM strategy in partnership with network managers and third-party vendor contracting agent.
Minimum Requirements:
- Requires BA/BS in Nursing, Pharmacy or Pharm D or MS in Social Work and minimum of 5 years of clinical or medical management experience; or any combination of education and experience, which would provide an equivalent background.
- Current, valid, active unrestricted license (RN, NP, RPh, MSW or LCSW) in applicable state(s) or territory of the United States required. Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Skills, Capabilities, and Experiences:
- Oncology Certified Nurse Certification preferred.
- Medical Oncology clinical experience preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Experience in oncology preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $105,336 to $180,576.
Locations: California; Colorado; District of Columbia (Washington, DC); Maryland, Nevada; New York; Washington State
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
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