Clinical Vendor Consultant

Capital Blue Cross•Harrisburg, PA

About The Position

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” Serves as a primary interface between clinical services and other departments to ensure multi- and inter-disciplinary vendor project coordination. Participates in communication and project planning regarding other company/department initiatives. Collaborates with clinical department directors and other key staff in overall project evaluation, Identifies key benchmarks for use in evaluation. Initiates and directs planning related to project development including identification of project objectives, expected outcomes, resource requirements and evaluation strategies. Professional who is trained to properly present data that supports clinical and business decisions. Assists clinical department directors and other in the interpretation and use of data for decision-making. Applies clinical knowledge and use of healthcare data to drive decisions. Present information to help organization leaders understand clinical impact of data to drive healthcare quality improvement. Improves and innovates the use of technology within clinical practice and workflows.

Requirements

Demonstrated excellent public speaking and written communication skills.
Experience leading a project resulting in positive change management
Project management
Knowledge of NCQA, JCAHO and American Accreditation HealthCare Commission/URAC standards.
5 years progressive clinical experience and/or informatics-related experience.
2 years experience in the health insurance, or other related healthcare field.
3 years of clinical and/or informatics-related experience
Bachelor’s degree in business, education or a health-related field or 9 years of relevant experience in lieu of degree.
Ability to work independently as well as collaboratively within a small team to meet quality and timeframe requirements is required.
Ability to handle multiple assignments with changing priorities is a ‘must’.
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
The employee must be able to work over 40 hours per week.
The employee must occasionally lift and/or move up to 5 pounds.

Nice To Haves

RN licensure preferred.

Responsibilities

Assists leadership to decide whether to add or replace a new service line to support member initiatives.
Oversight of external and internal sourced data management to include vendor reports.
Collaborate with internal vendor management to perform oversight of external vendor contracts as it relates to performance guarantees and service level agreements.
Interpretation of vendor reports to guide department/organization for clinical opportunities to impact lower cost of care, improve quality of care, and enhance member experience and member engagement.
Responsible for managing the relationships with specific vendors and serving as the organizations point of contact.
Analyzes and evaluates vendor proposals and assists in vendor selection.
Provides support to the organization for problems with vendor products and services.