Clinical Account Consultant RN

The cornerstone of the CAC RN role is to serve as a direct liaison between BCBSF strategic accounts and the clinical component of the health plan to provide more direct, efficient, and effective clinical analysis of group specific cost drivers and trends with identification of actionable opportunities and solutions targeted at existing and prospective cost drivers. The role is responsible for validating, analyzing, and interpreting information from highly technical business platforms (IT, Delivery, Service, Finance) to make effective cost, quality and shared decision-making recommendations resulting in increased client satisfaction and retention. Leverage problem solving skills and frameworks to develop solutions to client business problems. Conducts clinical analysis and provides input to customized evaluations which includes identification, interpretation and communication of overall account performance against benchmarks and clinical trends with account specific recommendations to improve performance and outcomes. Supports and delivers external presentations that demonstrate the value of products, programs and processes, as well as build an ongoing relationship with BCBSF. Supports external stakeholders in providing enhanced clinical analytics and decision support. Supports internal stakeholders in the development and implementation of market leading clinical analytics dashboards and solutions. Job duties include but aren’t limited to: • Validate, manipulate, analyze and interpret information from highly technical areas to make effective cost quality and process decisions with development of effective client specific initiatives resulting in increased satisfaction, retention and market competitive acquisition of new business • Identify multiple components of evolving health care strategies and opportunities through research and analysis processes including health care industry and market assessments, predictive modeling, benchmarking, competitor analyses, etc. • Translate corporate strategies into tactical application in the strategic account arena • Responsible for managing multiple groups, complex issues and projects simultaneously • Work collaboratively cross functional internal and external teams • Provide appropriate frameworks and processes to ensure consistency in decision-making • Prepare external client reports with delivery and presentation • Develop strong, trusted relationships with assigned groups, agents, consultants and brokers for continued retention Job Requirements: • 5+ years related work experience. Experience Details: Clinical experience, strong written and verbal communication skills, experience with web based tools, analytic platforms, proficiency with Microsoft Office applications (Excel, PowerPoint) • Related Bachelor’s degree or additional related equivalent work experience. Additional relevant work experience may be substituted for degree • RN - Registered Nurse - State Licensure and/or Compact State Licensure • CHC/PAHM within one year of employment • Experience in a matrix environment • Must have demonstrated communication and coordination skills managing multiple issues, including communications and planning • Proven ability to manage multiple complex business issues • Strong Care Management experience • Understanding of HIPAA regulations Strong business and analytics skills • Customer, Member and Sales centric • Strong demonstrated customer relations and relationship management skills • Experience with Microsoft Office applications: PowerPoint and Excel • Occasional travel Preferred: • Critical thinking skills, work ethic, motivated, personal initiative, maturity Project management training/experience • 3 or more years’ experience with account management General Physical Demands Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. Physical/Environmental Activities This position offers a hybrid work arrangement which combines flexibility with in-office engagement. Team schedules are determined based on role requirements and business needs. Travel to and from our corporate or regional offices may be required. What We Offer: As a Florida Blue employee, you will be at the heart of GuideWell’s vision – to lead the nation in transforming health through compassionate, connected, and technology-enabled care that delivers personalized value and empowered living. To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to: • Medical, dental, vision, life and global travel health insurance; • Income protection benefits: life insurance, short- and long-term disability programs; • Leave programs to support personal circumstances; • Retirement Savings Plan including employer match; • Paid time off, volunteer time off, 10 holidays and 2 well-being days; • Additional voluntary benefits available; and • A comprehensive wellness program Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ. To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases. Annualized Salary Range: $84,500 - $137,300 Typical Annualized Hiring Range: $84,500 - $105,600 Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.