Clinical Program Specialist - Remote

Overview

The Clinical Program Specialist blends expertise in dynamic project management responsibilities enabling impactful change across clinical teams to improve member/patient outcomes. The role will coordinate clinical and health equity initiatives, oversee aspects of clinical data, update resources, and serve as a central liaison across departments to drive continued success. They additionally will support clinical leadership by reviewing data and interacting with clinical care teams to ensure diagnostic and procedural coding requirements are met when assigned.

In Short

• Assist with implementing new initiatives as necessary, working in conjunction with various teams
• Oversee planning, execution, and completion of clinical initiatives
• Manage timelines and resources, identify risks, and maintain project documentation
• Develop and distribute regular reports to monitor project progress
• Act as a liaison between departments for clear communication
• Manage content on internal websites and SharePoint sites
• Partner with the Quality team for assessments and reporting
• Ensure reporting elements adhere to regulatory standards
• Lead efforts to implement coding updates
• Perform ongoing quality control for various outputs

Requirements

• Bachelor’s degree in health care or business related required, Masters preferred
• Five (5) years’ experience in healthcare required
• Certification or equivalent experience in Coding, Medical Risk Adjustment, and HEDIS required

Benefits

• Excellent communication skills and strong organizational skills
• Proficient in Microsoft Office and Optum EncoderPro 360
• Solid understanding of project management principles
• Proficiency in Business Intelligence visualization tools preferred
• Ability to work in a fast-paced environment
• Excellent presentation and interpersonal skills
• Strong strategic thinking and analytical skills
• Ability to manage multiple priorities