What are the responsibilities and job description for the Nursing Professional - Provider Outreach position at Louisiana Healthcare Connections?
Job Overview:
Louisiana Healthcare Connections is seeking a highly motivated Clinical Nurse to join our Medical Management/Health Services team. As a clinical professional, you will have the opportunity to make a meaningful impact on the lives of our 28 million members through provider outreach and performance improvement.
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.
- Implement and manage procedures for tracking, identifying, and resolving operational issues
- Represent the clinical perspective in various meetings
- 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
Responsibilities:
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.
