Vice President, Clinical Consulting
DescriptionAre you passionate about delivering trusted advice that improves lives?Are you a Clinical Consultant and expert with your advanced knowledge of the strategic and more technical complex health plan issues that is passionate about realizing significant opportunities with population health management programs such as onsite clinics, digital therapeutics, wellness, clinical audits, direct contracting, management of high cost claimants? Our opportunity may be for you!Key
Responsibilities:
Deliver consulting and client projects including clinical audits and onsite clinics and collaborate with client team to help clients maximize the value of their healthcare spendingAct as a technical resource, expert and advisor on complex plan issues and the management of population health management programs such as onsite clinics, digital therapeutics, wellness, clinical audits and direct contractingConduct extensive data analytics using claims data warehouse toolsDesign and implement onsite health optimization projects (e.
g.
, onsite clinics) including analyzing the effectiveness and efficiencyThrough deep technical data analysis, recognize trends and identify opportunities for clients and CRMsConduct and report on clinical audits of disease management programsDesign and develop internal tools and marketing collateral and sales support for vendor procurement, implementation and auditing of clinical servicesConsult directly to clients on plan design, care management, vendor selection, procurement, optimization, financial and regulatory aspects and identify and recommend innovative health and wellness strategies and initiatives such as digital therapeuticsCritically evaluate execution of vendor services in accordance with contracts and plan documentsDraft statements of work, project plans and budgets involving multiple workflow streams and client teamsSupport marketing and business development efforts involving health consulting nationwideConducting senior level peer review of practice-related work products and maintaining and/or enhancing standards for technical quality and professional competence relating to health consulting.
Qualifications Academic:
Undergraduate degree, advanced degree preferred.
RN, BSN, PA designation or other clinical background highly preferred Years of
Experience:
A minimum of twelve (12) years of health consulting experience and the ability to step into a role requiring significant business development, practice development, client relationship and leadership skills.
Experience could include consulting firms, hospitals and healthcare environment.
Work
Experience:
Demonstrated expertise in the design and administration of health plans and clinical care regimens.
Deep and broad-based expertise in health care, onsite clinic management and care regimes Experience with pre-certifications, medical records review and coordination of claims appeals resolution Previous expertise with launching and/or managing onsite clinics or telemedicine programs helpful Knowledge of HIPAA, COBRA, Health Reform, Medicare and Mental Health Parity laws Knowledge of patient cost-sharing, deductibles, copays, coinsurance and out of pocket limits Demonstrated experience and success in managing client relationships either on a primary or secondary basis and leading / participating in business development activities and other initiatives designed to grow revenue and profitability Large and/or complex/interdisciplinary-oriented project management experience Professional credential:
Professional accreditation as appropriate and relevant to the role and marketplace.
Technologies:
Proficiency in Microsoft applications (Excel, PowerPoint, Word) and use relevant data applications.
Hands on data analysis and report generation experience.
Knowledge of SQL preferred.
Skills/Traits:
Effective relationship builder and communicator (oral/written); analytical, creative problem-solver; innovative/contributor to best practice approaches and techniques; leadership who demonstrates the ideal behavior for others to emulate.
Diversity, Equity & Inclusion at Segal We recognize that individuals bring a broad range of experience and abilities that go beyond the technical requirements of a job.
If your experience and qualifications are close to what you see described here, we encourage you to apply.
Diversity of employment, skills and life experience, combined with passion, are key to innovation and excellence.
We encourage individuals, including but not limited to women, minorities, the disabled and protected veterans and those from all other backgrounds to apply to our positions.
Please let us know if you require accommodation during the interview process and thank you for considering Segal.
About Segal and its Total Rewards Program Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives.
Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segal s total rewards are part of what makes Segal a special place to work.
The current salary range for this position is $150,500 to $200,000 plus opportunity for a discretionary performance bonus with a target of 25% based on company profitability and employee performance.
In addition, Segal offers a comprehensive suite of benefits to include a non-contributory defined benefit pension plan, matching and discretionary contributions to a 401(k) profit sharing plan, medical and prescription benefits including contributions to a health savings account for eligible employees, dental benefits, life insurance, disability insurance, an Employee Assistance Program, wellness benefit reimbursements and rewards, and professional credential and tuition reimbursement.
Segal also provides comprehensive paid time off including holidays, vacation days, sick leave, paid family leave and sabbaticals.
Please Apply Segal is the right size, the right organization and the right move for you! Please apply now.
#LI-RemoteJob Field:
Consulting - Non-Actuarial BenefitsJob Type:
Regular EmployeeOrganization:
National OfficeSchedule:
Full-timeJob Level:
Experienced LevelTravel:
Yes, 25 % of the TimeEmployee Status:
Regular.
Estimated Salary: $20 to $28 per hour based on qualifications.
Responsibilities:
Deliver consulting and client projects including clinical audits and onsite clinics and collaborate with client team to help clients maximize the value of their healthcare spendingAct as a technical resource, expert and advisor on complex plan issues and the management of population health management programs such as onsite clinics, digital therapeutics, wellness, clinical audits and direct contractingConduct extensive data analytics using claims data warehouse toolsDesign and implement onsite health optimization projects (e.
g.
, onsite clinics) including analyzing the effectiveness and efficiencyThrough deep technical data analysis, recognize trends and identify opportunities for clients and CRMsConduct and report on clinical audits of disease management programsDesign and develop internal tools and marketing collateral and sales support for vendor procurement, implementation and auditing of clinical servicesConsult directly to clients on plan design, care management, vendor selection, procurement, optimization, financial and regulatory aspects and identify and recommend innovative health and wellness strategies and initiatives such as digital therapeuticsCritically evaluate execution of vendor services in accordance with contracts and plan documentsDraft statements of work, project plans and budgets involving multiple workflow streams and client teamsSupport marketing and business development efforts involving health consulting nationwideConducting senior level peer review of practice-related work products and maintaining and/or enhancing standards for technical quality and professional competence relating to health consulting.
Qualifications Academic:
Undergraduate degree, advanced degree preferred.
RN, BSN, PA designation or other clinical background highly preferred Years of
Experience:
A minimum of twelve (12) years of health consulting experience and the ability to step into a role requiring significant business development, practice development, client relationship and leadership skills.
Experience could include consulting firms, hospitals and healthcare environment.
Work
Experience:
Demonstrated expertise in the design and administration of health plans and clinical care regimens.
Deep and broad-based expertise in health care, onsite clinic management and care regimes Experience with pre-certifications, medical records review and coordination of claims appeals resolution Previous expertise with launching and/or managing onsite clinics or telemedicine programs helpful Knowledge of HIPAA, COBRA, Health Reform, Medicare and Mental Health Parity laws Knowledge of patient cost-sharing, deductibles, copays, coinsurance and out of pocket limits Demonstrated experience and success in managing client relationships either on a primary or secondary basis and leading / participating in business development activities and other initiatives designed to grow revenue and profitability Large and/or complex/interdisciplinary-oriented project management experience Professional credential:
Professional accreditation as appropriate and relevant to the role and marketplace.
Technologies:
Proficiency in Microsoft applications (Excel, PowerPoint, Word) and use relevant data applications.
Hands on data analysis and report generation experience.
Knowledge of SQL preferred.
Skills/Traits:
Effective relationship builder and communicator (oral/written); analytical, creative problem-solver; innovative/contributor to best practice approaches and techniques; leadership who demonstrates the ideal behavior for others to emulate.
Diversity, Equity & Inclusion at Segal We recognize that individuals bring a broad range of experience and abilities that go beyond the technical requirements of a job.
If your experience and qualifications are close to what you see described here, we encourage you to apply.
Diversity of employment, skills and life experience, combined with passion, are key to innovation and excellence.
We encourage individuals, including but not limited to women, minorities, the disabled and protected veterans and those from all other backgrounds to apply to our positions.
Please let us know if you require accommodation during the interview process and thank you for considering Segal.
About Segal and its Total Rewards Program Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives.
Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segal s total rewards are part of what makes Segal a special place to work.
The current salary range for this position is $150,500 to $200,000 plus opportunity for a discretionary performance bonus with a target of 25% based on company profitability and employee performance.
In addition, Segal offers a comprehensive suite of benefits to include a non-contributory defined benefit pension plan, matching and discretionary contributions to a 401(k) profit sharing plan, medical and prescription benefits including contributions to a health savings account for eligible employees, dental benefits, life insurance, disability insurance, an Employee Assistance Program, wellness benefit reimbursements and rewards, and professional credential and tuition reimbursement.
Segal also provides comprehensive paid time off including holidays, vacation days, sick leave, paid family leave and sabbaticals.
Please Apply Segal is the right size, the right organization and the right move for you! Please apply now.
#LI-RemoteJob Field:
Consulting - Non-Actuarial BenefitsJob Type:
Regular EmployeeOrganization:
National OfficeSchedule:
Full-timeJob Level:
Experienced LevelTravel:
Yes, 25 % of the TimeEmployee Status:
Regular.
Estimated Salary: $20 to $28 per hour based on qualifications.
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