Nurse Consultant II
Lee's Summit, MO
| Employer: | GEHA |
| Job Type: | Full Time |
Description | |
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GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees. GEHA has one mission: To empower federal workers to be healthy and well. Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization. The Nurse Consultant II provides professional nursing care to our members through the execution of key duties within the discipline of the Clinical Operations division. Incumbents at level II support members through assessment, evaluation, planning, and evidence-based research that promotes optimum health care and service delivery. Key responsibilities may include assessment of open gaps in care, education of the member on how to close those gaps, review of clinical history, and review of member's treatment plan against evidence-based medicine. Incumbents must possess the ability to actively engage and influence the member to modify behaviors and health care decisions in support of improved health through direct member contact and/or clinical and/or plan policy development and management. The Nurse Consultant II will be involved in research and development for policies and be a SME for those policies as needed. Incumbents must be independent and driven in decision making without having information clearly stated and comfortable using clinical judgement when guidelines are not established. In some cases, this may require coordination with key external vendors. Additionally, collaboration and communication with the member's family and health team, as well as internal and external business partners, is often necessary to promote evidence-based medicine and wellness, provide education and coordination of health care benefits, and facilitate member access to care in a timely and cost-effective manner. The Nurse Consultant II will ensure access to appropriate services across the healthcare continuum and maximize member benefits. Nurse Consultants at level II will serve as a clinical advocate for members and liaison within the division, among other departments and external health care teams. Use of systems to retrieve member information, document contacts, track member progress, and research evidence-based practice is required. Nurse Consultant II may manage a large, assigned member population, provide ongoing guidance and delegate appropriate tasks. The Nurse Consultant II will provide full principles of education and ongoing guidance necessary to implement policies and processes necessary to division operations and decision making as needed, and work with internal and external vendor partners across programs on internal processes and clinical reviews. Incumbent must be able to perform root cause analysis of trends, report out on findings and provide recommendations to address. SKILLS Key Duties
Requirements
#LI-Remote Preferred Requirements
Work-at-home requirements
How we value you
Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer. The annual base salary range for this position is $72,011 - $101,509 USD. GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization. GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles. | |