Role Overview:
The Care Management Solution Consultant acts as a Subject Matter Expert (SME) for MHK Care Management Clinical Solutions within CareProminence. This position supports both implementation for new clients and ongoing client production support. Provides input into ongoing product enhancements based on input from customers, vendors, regulation changes, and industry best practice standards. The ideal candidate has the product knowledge and passion to provide client’s with an efficient and compliant solution, improve the product line, and help drive innovation.
Responsibilities:
• Support client implementation of the Care Management software solution as a subject matter expert (SME) for the Utilization Management (UM) or Case Management (CM) MHK product
• Define product content and optimize workflow efficiencies to meet client business needs as well as meeting State and Federal regulatory / accreditation requirements
• Work closely with customers and other internal MHK teams such as; sales, project management, product, configuration and development staff for timely system implementation, continued product support and product enhancement
• Understand client business processes, define and translate requirements into standardized MHKK product solution (out of the box)
• Document and maintain use case requirements to test accurate system functionality testing
• Conduct end to end module testing to ensure accurate functionality prior to releasing to internal model and / or client environment
• Identify problems within the product and communicate them through established change management process, provide product approval as required by the release management process
• Able to adapt to competing demands, take on new responsibilities, and adjust plans to meet changing priorities
• Maintain positive, constructive approach to problem solving both internally and during customer interactions with focus on timely and accurate issue resolution
• Support new and existing clients to achieve efficiencies, accreditation and regulatory compliance
• Remain current with accreditation such as NCQA & URAC; State and Federal regulations (Medicare, Medicaid) and identify system enhancements to meet those requirements.
• Participate in MHK training sessions and / or client demonstrations to develop an overall understanding all MedHOK products
• Perform other duties as assigned
Education, Training and Experience:
• Healthcare/Management degree preferred. In lieu of education, at least five years’ experience within MHK or equivalent experience in Product implementation.
• Utilization Management and/or Case Management experience, required
• Related work experience, including experience translating business requirements into system configuration and requirements.
• Experience in working with Health Plan clients or vendor personnel of all management levels
• Excellent interpersonal skills with strong oral communication skills with all levels within organizations
• Experience working with/knowledge in CMS, NCQA and/or URAC or other Health Plan accreditation
• Excellent written, verbal communication and interpersonal skills
• Proficient with Word, Power Point, Excel, Visio and Document Management software
• Proven ability to work effectively both independently and in a team environment, required
• Up to 30% travel to client locations may be required
management Employment Type: OTHER