Clinical Program Specialist

Job Description

This position has accountability for supporting the Clinical Administration Team. This position will play a critical support role in improving Prospect’s Medical Management infrastructure and processes. Tasks include but are not limited to the following: clean and manipulate data files as needed for analysis, conduct quality assurance checks on data output and generated reports, prepare data analysis results for medical leadership (charts, etc. in excel), collect data using standardized protocols, and provide project management and administrative support to the Clinical Administration team. The Clinical Program Specialist will act as a resource and subject matter expert on Clinical Administration projects. Assist with provider and vendor engagement. Help maintain policies and procedures, job aids, and workflows. Assist the Clinical Administration Team and support a team approach. This position will provide analytic support for the new clinical program and project initiatives.

Job Knowledge, Skills And Abilities

To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Experience working in electronic data systems and proficient in MS Excel, and Microsoft suite programs
• Demonstrated ability to meet timeliness standards within a highly demanding work environment
• Excellent communication and interpersonal skills and ability to work as part of a team
• Exceptional customer service and conflict resolution skills.
• Proficient in presentation software, including Powerpoint, Visio, etc
• Strong organizational skills
• Must be able to work independently.
  
  

Required Education/Experience

• Some college: Associate in Arts degree preferred
• Project Management Experience
  
  

Preferred Education/Experience

• Knowledge of Six Sigma
• 3+ years’ experience in medical management
• Knowledge of managed care and healthcare.
• Equivalent experience will be considered.
  
  

Location - Based Pay Adjustment

About Us

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.