Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

ACO Clinical Practice Advisor

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Manager & Professional
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1915L Requisition #
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The ACO Clinical Practice Advisor (CPA) is a self-directed, creative professional who thrives in an innovative health care environment and is driven to achieve targeted goals. Partners with Physician Groups engaged in Value-Based, Shared Savings/Shared Risk contracts to design, build, implement, and evaluate sustainable, cutting-edge evidence based practices to improve patient outcomes and achieve cost savings metrics. Motivates group to succeed.  Identifies and overcomes barriers limiting the Group’s potential for success. This is an office based position which requires working onsite with the Group as needed. 

Responsibilities:
  • Identifies members with high potential to benefit from targeted Care Coordination/Management interventions
    • Communicates information to Physician Group designee in a timely manner
    • Arranges recurring appointments with designated staff to:
      • Discuss high potential members 
      • Advise community based, disease management, and care management resources as appropriate to meet the needs of each patient
      • Assists to resolve barriers to members’ access to resources; escalates to Director as needed
      • Assists obtaining approval of Physicians orders as needed
      • Records and tracks member outcomes
  • Independently establishes relationships with assigned Physician Group(s) administrative and clinical staff
  • Participates in monthly and quarterly meetings to support mutual understanding of shared goals and objectives
  • Educates administrative and clinical staff:
    • Goals/objectives of Shared Savings/Risk Programs.  
    • Use of EmblemHealth Clinical Reports  
    • Evidence based practices related to Care Management/Coordination
  • Utilizes a variety of reports to track clinical and utilization trends and minimize clinical risk
    • Works with Emblem Health Contractors to identify root cause for improvement or decline.  
    • Reports findings to Director Clinical Effectiveness; collaborates to develop plan to correct decline/share improvement practices
  • Assists Director, Clinical Effectiveness to implement Value Based Contracting Best Practices 
  • Executes other duties as required or assigned
Qualifications:
  • Bachelor’s Degree required
  • Active, unrestricted NYS Licensed LPN, RN, or Certified Social Worker required
  • Minimum 4-6 years’ clinical experience required
  • Success in self-directed environment, with an ability to work with and lead non-traditional teams required
  • Computer literate; Microsoft Office competency required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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