Healthcare Consultant II

Candidates must fit into one of the following locations/regions

Targeted Posting

Lorna Waithaka

Source in the following locations:

1
Arlington
2
Alexandra
3
Falls Church
4
Annandale
5
Vienna
6
Springfield
7
Mclean
8
Fairfax


Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues

Determines medical necessity/ appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities
May also include identification of aberrance's and initiation of corrective action Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate/empower colleagues at all levels to enable decision making at most appropriate level

Position Summary:

Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively
manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues

Duties:

Determines medical necessity/ appropriateness
Facilitates optimal outcomes
Identifies and follow through with continuous quality/ compliance opportunities
May also include identification of aberrance's and initiation of corrective action
Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
Optimize total costs
Implementation and evaluation of policy based on usage and program directives
Educate/empower colleagues at all levels to enable decision making at most appropriate level

Experience:

Required Qualifications:
RN with current unrestricted Virginia state licensure required.
3 years clinical experience (for example med surg or behavioral health)
Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
Effective communication skills, both verbal and written.

Preferred Qualifications:
Managed Care experience, Case Management experience in an integrated model
5 years clinical practice experience
Bilingual

Education:

Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively
manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues