Nurse Clinical Acct Consultant/Sr - 59261 - S.Portland, ME vacancy at WellPoint in South Portland

WellPoint is in need of Nurse Clinical Acct Consultant/Sr - 59261 - S.Portland, ME on Fri, 17 Aug 2012 06:45:04 GMT. Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities. Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine. Nurse Clinical Acct...

Nurse Clinical Acct Consultant/Sr - 59261 - S.Portland, ME

Location: South Portland Maine

Description: WellPoint is in need of Nurse Clinical Acct Consultant/Sr - 59261 - S.Portland, ME right now, this vacancy will be placed in Maine. Further informations about this vacancy opportunity kindly read the description below. Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Nurse Clinical Acct Consultant/Sr - 59261 - S.Portland, ME

• Level will be determined based on the skills/experience of those selected for final consideration.

The Nurse Clinical Account Consultant Sr is responsible for identifying opportunities to positively impact member health as well as the financial well-being of employer group, Maine Education Association through clinical and data analysis and extensive knowledge of the healthcare industry.

The candidate will be an active participant in providing the Maine Education Association with insightful interpretive analytics of the medical plan’s key cost drivers and offer strategic recommendations based upon the medical plan design and clinical program utilization data. The candidate will work with the account management team, and others as requested, to provide strategic recommendations that will improve the value of the health plan and promote wellness.

Essential duties include but are not limited to:

• Provides healthcare clinical and data analysis providing appropriate information for the Client, collaborates with key

areas of the organization to present a comprehensive, integrated healthcare analysis for the Client through presentations, written documents, and executive summaries.

• Participates in strategic presentations as needed to define and support the Company’s overall mission. Providing

insightful guidance and interpretation of the data, and preparing presentations that the account management team can utilize in a consultative manner with the Client are major contributions to this position.

• Provide review and analysis of health care and disease trends of the Clients covered employees and provide

recommendations on optimizing programs to reduce trends and/or implement new benefit plans

• Develops action plans and assists in planning initiatives to address areas for improvement identified through clinical

and data analysis and business expertise.

• Stays abreast of latest trends in the healthcare industry as well as the latest competitor offerings.
• Educates Client on industry trends and impact of these trends on their cost and utilization and Client experienced

relative to trends.

• Provides subject matter expertise with internal business partners to improve the efficiency and continuity of group

information, serving as an advocate for the customer.

• Performs strategic clinical and data analysis and research as appropriate to support business needs.
• Deliver quarterly presentations for Client and account management team.
• Work closely with care and case management, vendor liaisons, other clinical professionals and Client to assist in

coordination of activities, such as care management, among providers, members and other services.

• Track process and outcomes of Client initiatives based on data and established benchmarks.
• Work with providers and provider organizations as requested/directed by the client.
• Performs other duties as assigned.
• Requires a BS in nursing, 5 years clinical practice experience, and 3 years of managed care experience, or any combination of education and experience, which would provide an equivalent background.
• Requires current unrestricted RN license in Maine.
• 3 years of experience in data analysis and reporting is required.
• Strong analytical, organizational, and problem-solving skills, along with good written communication skills required.
• Strong Information Management background including expertise in Excel, Access, and experience working with data extracts.

WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, one of the 100 Best Places to Work by Working Mother magazine, and is a 2011 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.wellpoint.com/careers . EOE

Job Qualifications

Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).

• Current WellPoint associates: All referrals must be submitted through the formal

associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.

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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to WellPoint.

If you interested on this vacancy just click on the Apply button, you will be redirected to the official website

This vacancy starts available on: Fri, 17 Aug 2012 06:45:04 GMT

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