What are the responsibilities and job description for the Clinical Liaison position at Louisiana Healthcare Connections?
Job Summary:
We are seeking a skilled Clinical Nurse to serve as a liaison in the Baton Rouge and New Orleans areas, focusing on provider outreach. This hybrid role involves three days of in-field visits to facilities and two days of remote work dedicated to documentation and outreach.
The primary objective of this position is to drive provider performance improvement in key areas, including Risk/P4Q, HBR, HEDIS/quality, cost, and utilization. The successful candidate will evaluate provider performance, develop strategic plans to enhance performance, and perform detailed HBR analyses.
In addition to these responsibilities, the clinical professional will facilitate provider trainings, orientations, and coaching for performance improvement within the network. They will also assist with claim resolution, implement procedures for tracking and resolving operational issues, and represent the clinical perspective in various meetings.
- Develop and manage data-driven analysis and metrics to measure effectiveness and ROI of current and new products
- Collaborate with staff to identify opportunities and initiate process changes to increase quality and improve staff, provider, and member satisfaction
- Serve as a resource and liaison on utilization, quality improvement, and case management activities
- Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data, and quality incentive payments
- Support community and member initiatives with a focus on at-risk targets
Requirements:
A minimum of four years of clinical nursing experience, preferably in a large primary care office or clinic setting working with Medicaid or the uninsured. Experience in conflict management, data reporting, or evaluation is beneficial. Managed care, utilization management, case management, or quality improvement experience is preferred but not required.
