Advanced Clinical Advocate Nurse Practitioner

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Act as a clinical resource for intricate pharmacy and imaging-related cases.

• Work in conjunction with providers to clarify clinical requirements, treatment objectives, and necessary clinical information.

• Assess clinical situations and pinpoint opportunities to facilitate timely access to suitable care and services.

• Utilize advanced clinical judgment to bolster evidence-based decision-making.

• Aid in resolving complex clinical inquiries alongside providers, pharmacists, nurses, and interdisciplinary teams.

• Engage in clinical outreach and provider-to-provider consultations concerning intricate care requests.

• Collaborate with ordering and prescribing providers to comprehend clinical circumstances and treatment ambitions.

• Establish cooperative relationships with provider partners and act as a reliable clinical resource.

• Serve as a clinical intermediary among pharmacy, imaging, operational, and clinical teams.

• Escalate clinically complex cases when further expertise or review is necessary.

• Enhance efficient care coordination and minimize obstacles impacting treatment initiation.

• Foster a seamless provider experience through proactive communication and teamwork.

• Recognize patterns, opportunities, and challenges that impact care access and provider experience.

• Offer feedback on clinical documentation, workflows, and initiatives for process improvement.

• Participate in quality, compliance, and clinical calibration efforts.

• Contribute to initiatives aimed at enhancing care access, provider satisfaction, and the overall healthcare experience.

• Promote continuous improvement centered on clinical quality and operational excellence.

• Assist providers, members, and internal clinical teams in navigating intricate pharmacy and imaging-related care requirements.

• Please note that this position does not involve direct patient care and does not provide retail, primary care, urgent care, or in-home clinical services.

⛳️ Requirements

• Active and unrestricted Nurse Practitioner license with the capacity to acquire and maintain multi-state licensure as needed.

• Current national board certification through ANCC, AANP, or another recognized certifying body.

• At least five (5) years of advanced clinical practice experience.

• Proven clinical expertise in complex care management, specialty care, managed care, pharmacy, imaging, utilization support, or related healthcare environments.

• Strong clinical assessment, critical thinking, and decision-making abilities.

• Experience collaborating directly with physicians, specialists, and advanced practice providers.

• Exceptional verbal and written communication capabilities.

• Ability to interpret clinical data, evidence-based guidelines, and healthcare policies to provide informed clinical recommendations.

• Experience in supporting pharmacy and/or imaging-related clinical programs.

• Previous experience in managed care, health plans, payers, specialty care, or population health.

• Experience conducting provider-to-provider clinical consultations.

• Familiarity with evidence-based clinical guidelines and clinical decision support tools.

• Experience working with Medical Directors and interdisciplinary clinical leadership teams.

• Understanding of healthcare regulations, accreditation standards, and quality improvement methodologies.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer.

• Minimum internet speed of 25 Mbps download and 3 Mbps upload.

• A quiet, secure, private home workspace that complies with CVS Health and HIPAA guidelines.

• Must work within the state and city where currently residing.

• Must provide workspace furniture, such as a desk or standing desk.

• Comfortable with setting up and using multiple monitors and navigating several applications simultaneously.

• Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings.

• Proficient in Microsoft Office 365 applications or similar tools like Google Workspace.

• Capable of logging into secure systems such as VPN and EHR portals.

• Must adhere to computer security practices, including screen locking, managing strong passwords, and identifying suspicious emails or links.

• Ability to independently resolve common technical issues.

🏝️ Benefits

• Medical coverage

• Dental coverage

• Vision coverage

• Paid time off

• Retirement savings options

• Wellness programs

• Additional resources supporting physical, emotional, and financial well-being

• Company-provided equipment (keyboard, monitor, computer, headset, etc.)