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Clinical Consultant I

Role overview

Qualifications

  • Bachelor of Science in Nursing (BSN) required
  • Experience working with payer organizations or payer-focused workflows required or strongly preferred
  • Effective communication and facilitation skills
  • Ability to interpret basic clinical and utilization data

Responsibilities

  • Support assigned payer client implementations through prescriptive workflow execution and system build input
  • Deliver end-user and super-user education using adult learning principles
  • Monitor standard KPIs (e.g., authorization timeliness, denial trends, exception rates, throughput indicators)
  • Partner with Client Delivery, Value Realization Partner (VRP), and Client Relationship Executive (CRE) teams to support payer implementation and early value realization

Key facts

Other skills

  • Training And Development
  • Communication
  • Adaptability
  • Collaboration

About the company

XSOLIS logo

XSOLIS

XSOLIS is a platform, data science and solutions innovator serving health plans, hospitals and payer organizations nationwide to create a more efficient healthcare system. Through its purpose-built solutions and industry-leading AI, XSOLIS breaks down healthcare silos to accelerate data-driven decision making and collaboration across a connected network of providers and payers. CORTEX®, its AI-driven technology platform, is the first and only solution to use real-time predictive analytics to continuously assign an objective medical necessity score and assess the anticipated level of care for every patient. CORTEX eliminates waste through the science of data using automation, transparency and objective insights to ensure appropriate care settings, enabling more efficiency across the healthcare system. XSOLIS is headquartered in Nashville, Tennessee. Our Values - Team First - Client Passionate - Always Curious - Deliver Excellence XSOLIS recently ranked No. 1795 on the 2022 Inc. 5000 list, the most prestigious ranking of the fastest-growing private companies in America, and was named 2022 Best in Business among private companies by the Nashville Business Journal. XSOLIS executives have been featured in Becker's Hospital Review, Becker's Payer Issues, Chief Healthcare Executive, CIO Review, Managed Healthcare Executive, Healthcare IT Today, among other leading publications. For more information, visit www.xsolis.com.

Company details

Company size201 - 500

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Job description

Redefining Healthcare with AI 

Xsolis is an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Since 2013, our vision has been to create a frictionless healthcare system.  

We are proudly headquartered in Franklin, TN - one of the nation's fastest-growing hubs for healthcare innovation - we are at the heart of a thriving ecosystem of health systems, payers, and technology leaders.  

Our flagship product, Dragonfly®, is the first and only AI-driven platform to continuously assign real-time predictive scores for medical necessity. Dragonfly has delivered proven results across 600+ hospital, health system, and health plan clients and earned repeated industry recognition. With recognition on the Inc. 5000  and Deloitte Technology Fast 500 lists, Xsolis is also one of the fastest-growing privately-held companies in the country and across North America, and we're looking for talented people to grow with us.   

Position Summary Details

The Clinical Consultant (CC) – Level I supports assigned payer and provider clients by providing foundational clinical support 
across implementation, go-live, and post–go-live optimization of XSOLIS solutions. This role applies core Case 
Management (CM) and Utilization Management (UM) knowledge to support payer workflows, platform adoption, 
and identification of early performance and value opportunities. 

CC Level I supports clinical implementation and go-live activities, including assisting with prescriptive workflow 
execution, contributing to system build and configuration, and delivering education to super users and end users 
using adult learning principles. Following go-live, this role reinforces workflows, identifies adoption gaps, and 
supports interpretation of clinical and utilization data to promote compliance and early performance 
improvement
 
Essential Duties & Responsibilities

The essential functions include, but are not limited to the following:
  • Clinical Implementation Support 
    • Support assigned payer client implementations through prescriptive workflow execution and system 
    build input. 
    • Participate in implementation meetings, milestone tracking, and readiness activities. 
    • Deliver product demonstrations and introduce standard analytical reporting as directed. 
    • Support training development and execution using established materials and workflows.
  • Training, Adoption, and Execution 
    • Deliver end-user and super-user education using adult learning principles. 
    • Conduct remote and onsite training as assigned and support early go-live adoption. 
    • Participate in focused workflow discussions and payer-specific operational reviews when requested. 
    • Reinforce standard utilization and authorization workflows aligned with payer requirements.
  • Post-Implementation Optimization 
    • Monitor standard KPIs (e.g., authorization timeliness, denial trends, exception rates, throughput 
    indicators). 
    • Review dashboards and reports to identify adoption or utilization concerns. 
    • Support corrective actions aligned with established payer best practices. 
    • Escalate risks, barriers, or performance concerns through established channels.
  • Client Partnership and Internal Collaboration 
    • Partner with Client Delivery, Value Realization Partner (VRP), and Client Relationship Executive (CRE) 
    teams to support payer implementation and early value realization. 
    • Participate in preparation sessions and support clinical components of Business Reviews.

This role will require you to travel to clients. 

Minimum Qualifications (Knowledge, Skills, and Abilities) 
 
Education: 
  • Bachelor of Science in Nursing (BSN) required
  • ACM or CCM preferred
Experience: 
  • Experience working with payer organizations or payer-focused workflows required or strongly preferred
  • Experience supporting clinical technology adoption and/or training initiative
  • Experience with Utilization Management
Other:
  • Effective communication and facilitation skills
  • Ability to interpret basic clinical and utilization data
  • Adaptability to new technologies and workflows
  • Professional, detail-oriented, and collaborative approach
Supervisory Responsibilities

This role does not have any direct reports and is a single contributor role.
 
Working Environment and Travel Requirements
  • Work is typically in a normal office administrative environment involving minimal exposure to physical risks.
  • Position requires little to moderate physical activity. Mostly sedentary work exerting up to 10 pounds of force occasionally or a negligible amount of force to lift, carry, push, pull, or otherwise move objects. Work involves sitting most of the time, but may involve walking or standing for brief periods of time. No significant stooping is usually required.
  • This role requires travel to our home offices in TN for training. 
Physical Demands & Work Environment 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position.
 
Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

In any role at Xsolis, it's a chance to make a complex healthcare system a little more efficient alongside a team that's passionate, fast-moving, and genuinely invested in your success. Your contributions will shape both our product and our culture.  

Full-time Employees’ Total Rewards package include:  

  • Medical/Dental/Vision insurance 
  • 401K company match 
  • Flexible Paid Time Off 
  • Paid parental leave  
  • HSA/FSA options 
  • Educational reimbursement program 
  • Employer-paid EAP & Mental Health services 

 

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Xsolis is proud to be an equal opportunity employer. We celebrate diversity and are committed to building an inclusive environment for all. We encourage candidates of every background to apply. 

All candidates must successfully pass a background check and fall under the same security role, which includes access to sensitive information, including proprietary data and PHI. 

Work Authorization Notice: Please note that we do not provide visa sponsorship or immigration support for this position. Applicants must already be authorized to work in the United States on a full-time, permanent basis without the need for current or future sponsorship. 

All official communications from our recruitment team will only come from @xsolis.com. Verify open roles at https://www.xsolis.com/about/careers. For information regarding how we collect, use, and protect applicant personal information, please review our CCPA Privacy Notice for Job Applicants. 

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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