Location: Henderson Rd, Tampa, FL 33634
Department: Health Services
Reports to: Sr Manager, Care Management
Works collaboratively with various levels of clinical staff and Information Systems staff to clarify needs, prioritize requests, and recommend workflow enhancements. Responsible for evaluating and documenting clinical processes, including step actions and workflows to construct and enhance the clinical model of care.
- Serves as a clinical resource for an assigned work stream unit - Intake, UM, CM, DM, Reporting or Appeals.
- Assists in the documentation and gathering of detailed requirements and workflow processes and analysis.
- Reviews current workflow and lead recommendations and defines requirements to build processes and forms needed to support the business in the new system.
- Recommends and implements software based on best practices.
- Analyzes customer needs and identify system and procedural solutions to enhance the clinical practices.
- Identifies opportunities to leverage technologies in areas that improve and promote the clinical agenda.
- Performs gap analysis.
- Identifies needed process changes to ensure compliance with the use of technology to optimize care delivery processes and effectively communicate patient care activities.
- Performs application testing and creates test scripts – SIT/UAT.
- Develops and creates test plans for SIT and UAT.
- Performs UAT Testing.
- Works with IT to resolve update issues.
- Communicates with internal partners to obtain sign-offs.
- Ensures updates are tested and applied on a timely basis.
- Provides documentation and training as needed.
- Insures technology meets Compliance and Regulatory Requirements.
- Performs other duties as assigned.
- Required: Bachelor's Degree in a related field; or 5 additional years of relevant work experience required in lieu of Bachelor's Degree
- Required: 3 years of experience in a managed care organization using clinical skills
- Required: System implementation experience
- Preferred: 1 year of experience in Utilization Management and/or Care Management
Licenses and Certifications:
- Demonstrated written communication skills
- Demonstrated interpersonal/verbal communication skills
- Ability to effectively present information and respond to questions from peers and management
- Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
- Ability to work as part of a team
- Ability to work independently
- Ability to work in a fast paced environment with changing priorities
- Demonstrated organizational skills
- Ability to remain calm under pressure
- Ability to work overtime as required
A license in one of the following is required:
- Microsoft Outlook
- Microsoft Word
- Microsoft PowerPoint
- Microsoft Excel
- Microsoft Access
- Microsoft Visio