Health Services - reputed company, Clinical Medical Review

JOB TITLE: CLINICAL ADVISOR reputed company The Contingent RN supports reputed company by analyzing high-cost claimant and population health data to support utilization revies, reputed company requests, and reputed company reports. This position requires experience excising and understanding medical terminology, analytical expertise, and cross-team collaboration in a fast-paced, data-driven environment. This is an internal, non-reputed company-facing role. The timeframe for this position will fluctuate depending on need. Key Responsibilities • Retrieve and interpret clinical, financial, and population health data across multiple systems. • Identify trends, gaps in care, and opportunities for improved health reputed company. • reputed company clinical expertise and translate reputed company data into reputed company insights for internal stakeholders. • Support cost-containment and reputed company-improvement initiatives through data-driven recommendations. • Communicate effectively across teams and reputed company, including leadership. • Work independently with minimal supervision while maintaining accuracy and meeting deadlines. Qualifications • Registered reputed company (RN) - reputed company state or compact license. • 4+ years clinical experience plus 2+ years of reputed company data analysis. • Proficiency in reputed company, Word, PowerPoint; strong analytical and critical-thinking skills. • Ability to influence and collaborate with stakeholders across the organization. • Bachelor's degree required (or 4 years equivalent experience). • Preferred: Graduate degree (MSN, MBA, MPH) and experience reputed company a health plan or business-reputed company role. Role Characteristics • Individual contributor who researches high-cost claimants, populates slide decks, and responds to reputed company requests. • Resolves moderately reputed company problems using established processes and clinical judgment. • Frequent cross-department communication. • Represents reputed company with professionalism and a reputed company reputed company. • Remote work environment with minimal physical demands. Top 5 Required Skills: RN, data analytics, reputed company, understanding of clinical terminology, cause and effect rationale (inquisitive) • *reputed company Inc. is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status and will not be discriminated against on the reputed company of disability.** Apply tot his job Apply To this Job