Clinical and Regulatory Program Consultant

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

📋 Description

• Collaborates effectively with implementation and support teams to ensure that client business and clinical requirements are thoroughly captured and addressed during the implementation process and beyond.

• Acts as a subject matter expert on clinical best practices and health plan regulatory compliance, ensuring that ZeOmega’s solutions are in alignment with industry standards and fulfill client needs.

• Aims to improve the end-user experience by advocating for usability and workflow efficiency.

⛳️ Requirements

• In-depth knowledge of California regulations and experience within health plans.

• At least 3 years of clinical experience, ideally in a managed care or health plan environment.

• Strong understanding of DHCS regulations, Medi-Cal program policies, and California state healthcare compliance requirements.

• Acquainted with DHCS All Plan Letters (APLs), Medi-Cal Managed Care contracts, and associated reporting requirements.

• Proven experience working with health plans, including utilization management, case management, or care coordination.

• Familiarity with healthcare IT platforms and solutions for population health management.

• Capability to manage multiple projects and adhere to deadlines in a dynamic environment.

• Prior experience in consulting or the implementation of healthcare technology solutions is advantageous.

• Proficient in clinical best practices and regulatory compliance for health plans.

• Strong communication and presentation abilities.

• Competence in analyzing business requirements and converting them into solution designs.

• A current and unrestricted US LPN or RN license is required.

🏝️ Benefits

• Competitive salary and comprehensive health benefits.

• Opportunities for professional development and continuing education.

• Flexible work arrangements to promote work-life balance.

• Supportive team environment fostering collaboration and innovation.