Clinical Consultant

The Clinical Consultant is a senior clinical and operational expert with deep experience across the integrated spectrum of Care Management services, including Care Management (CM), Utilization Management (UM) and Complaints, Appeals & Grievances (CAG). This role advises health plan and payer executives on implementing best-practice workflows that strengthen compliance, improve health outcomes, and drive meaningful operational efficiency.

Requirements

• 5+ years in clinical consulting, healthcare technology, or solution implementation preferred
• Strong knowledge of regulatory requirements, payer workflows, and clinical quality programs (HEDIS, Stars preferred)
• Proven ability to influence senior stakeholders, lead complex engagements, and drive measurable operational improvements
• Exceptional communication, facilitation, and problem-solving skills

Benefits

• Medical, vision, and dental plans for full time employees
• 401(k) offered with a generous match
• Exercise/Health Club reimbursement opportunity
• Monthly dependent care reimbursement opportunity
• Short Term and Long Term disability
• Basic Term Life and AD&D Insurance
• Paid Time Off
• 18 days Paid Time Off
• 15 Company Paid Holidays