Remote Clinician Specialist (UM), Multiple Locations - Remote Eligible

✨ About The Role

- The Clinician Specialist will provide clinical and operational support to the department related to utilization management and case management - Responsibilities include drafting clinical guidelines, monitoring department SOPs, and developing member and provider letters - The role involves researching industry best practices to contribute to the development of guidelines, policies, and procedures - The Clinician Specialist will measure and evaluate department performance, summarize data, and communicate progress to management - Additional duties include collaborating with department trainer and supervisory staff, reviewing regulatory updates, and participating in department projects

⚡ Requirements

- Ideal candidate will have a Master's degree in a related field and 3-5 years of relevant experience - Experience with MCG clinical guidelines is required for this role - Strong organizational skills and ability to develop and implement clinical documentation - Ability to collaborate with internal stakeholders and assist in policy development and modification - Detail-oriented individual with the ability to measure and evaluate effectiveness of workflows and processes