Practice Consultant

Elevance Health • Walnut Creek, CA

1d • $40 - $63 • Hybrid

About The Position

Practice Consultant Locations: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. Monday – Friday 8-5 pm PST hours. The Practice Consultant is responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this fully integrated and accountable system of care, while serving as a member advocate responsible for identifying and closing gaps in care access and coordination.

Requirements

• Requires AS in nursing and minimum of 5 years of managed care experience and minimum of 2 years of clinical experience and minimum of 2 years of professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted clinical license appropriate to field of specialty (LVN/LPN, RN, NP, PA, LCSW, LSW, etc.) as required.

Nice To Haves

• BSN or MSN is preferred.
• RN case management or UM experience is preferred.

Responsibilities

• Assesses current practice patterns, assets and challenges utilizing Medical Home Index, NCQA Standards, HEDIS audits, site reviews and medical records reviews.
• In partnership with the PCP, evaluates results of the initial assessment.
• Establishes a project plan with the practice that establishes goals and objectives for improvement.
• Provides ongoing practice support and sustains the partnership.
• Establishes regular meetings to track progress.
• Acts as a care navigation liaison between members, providers, Member Services, and Case Management by facilitating follow-up care, wellness and preventive education, and addressing member needs that fall outside of catastrophic case management but exceed routine customer service.
• Improves the understanding and sensitivity to the unique needs of this population and the care givers, including proactive advocacy for timely, appropriate, and coordinated care.

Benefits

• In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree