Clinical Product Consultant - UM

Job Summary

Required Qualifications

• Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure)
• 8+ years of clinical experience in acute care setting
• 2+ years of experience in utilization management
• Accomplished speaker, presenter, and influencer
• Experience managing a Utilization Management team in an acute care setting
• Knowledge and understanding of Utilization Management, Quality Management, Care Management, and/or Chronic Condition Management within hospital systems, post-acute providers, and/or payers
• Demonstrates an understanding of evolving reimbursement models including commercial payers, Medicaid, and Medicare
• Demonstrates an understanding of CMS regulations as it pertains to IPPS and OPPS
• Works effectively on a multidisciplinary team
• Demonstrates the ability to lead and manage projects
• Demonstrates flexible, positive, clear interpersonal and communication skills
• Ability to effectively and efficiently work remotely
• Proven history of collaborative, team-focused approach
• Excellent oral and written communication skills
• Ability to travel 20-50% of the time to domestic locations for client or business meets

Desired Qualifications

• Experience as Senior Leader (Director or VP) of Utilization Management in acute care setting
• Active and current Case Management Certification
• 2-3 years’ experience with MCG and/or Interqual products and services
• Healthcare Consulting experience
• Experience in software training and education for healthcare-related products
• Knowledge of core software applications including Google, Excel, PowerPoint