Elevance Health - Mason, OH

posted 2 months ago

Full-time - Mid Level
Mason, OH
11-50 employees
Insurance Carriers and Related Activities

About the position

The Oncology Practice Enablement Clinician at Carelon Medical Benefits Management is responsible for building and managing relationships with oncology practices to enhance care quality and value through strategic solutions. This role focuses on practice collaboration and enablement within a Value Based Network (VBN) aimed at optimizing the Total Cost of Care (TCOC) in oncology. The clinician will provide training, support, and data analysis to improve practice performance and ensure effective implementation of oncology care initiatives.

Responsibilities

  • Independently manage relationships with provider practices, providing orientation, ongoing training, and support.
  • Onboard practices to the VBN program.
  • Provide ongoing support through Practice Support breakout meetings to meet practice needs.
  • Partner with PTC to implement and monitor practice transformation efforts.
  • Conduct regular clinically-focused, cross-functional strategic committee meetings (JOCs) to assess and evaluate practice-specific quality and performance metrics.
  • Schedule and host regularly scheduled meetings (JOCs) and breakout practice support meetings as needed.
  • Conduct deep dives into specific quality measures and host review meetings with practices as needed.
  • Oversee and partner with PTCs to perform data analysis to identify trends in quality data.
  • Review areas of improvement within JOCs and outreach to practices as needed.
  • Serve as the subject matter expert for provider practices regarding all company programs and care management initiatives.
  • Stay updated on all VBN program communications and disseminate information to practices.
  • Educate practices on organizational solutions to improve quality and cost of care.
  • Maintain understanding of oncology and palliative care clinical domains and industry changes.
  • Host internal Provider Enablement team education sessions annually.
  • Partner with organizational teams to host program-specific meetings and educate practices on solutions supporting practice transformation.
  • Serve as a liaison with state and regional provider contracting account managers and third-party contracting agents for the VBN program.
  • Execute GTM strategy in partnership with network managers and third-party vendor contracting agents.

Requirements

  • BA/BS in Nursing, Pharmacy, or Pharm D.
  • Minimum of 5 years of clinical or medical management experience, or equivalent education and experience.
  • Current, valid, active unrestricted license (RN, NP, or RPh) in applicable state(s) or territory of the United States required; multi-state licensure is required if providing services in multiple states.

Nice-to-haves

  • Oncology Certified Nurse Certification preferred.
  • Medical Oncology clinical experience preferred.
  • Strong oral, written, and interpersonal communication skills.
  • Problem-solving, facilitation, and analytical skills.

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
  • Paid holidays
  • Paid Time Off
  • Medical, dental, and vision benefits
  • Short and long-term disability benefits
  • Life insurance
  • Wellness programs
  • Financial education resources
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