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Remote Project Leader Clinical Licensure Program

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR6814

Location:

  • Illinois, Illinois
  • North Carolina, North Carolina
  • Iowa, Iowa
  • Indiana, Indiana
  • Wisconsin, Wisconsin
  • Virginia, Virginia
  • Minnesota, Minnesota
  • Ohio, Ohio
  • Kentucky, Kentucky
  • Arkansas, Arkansas
  • Tennessee, Tennessee
  • West Virginia, West Virginia
  • Montana, Montana

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Description

Build the Possibilities. Make an extraordinary impact.
A proud member of the Anthem Inc family of companies, myNEXUS is the leader in health resource optimization, focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve.

Job Title: Project Leader Clinical Licensure Program
Work Schedule: Mondays to Fridays, 8A to 5P CST


Location: 100% Remote / Work From Home (Considering candidates throughout the US who are able to work CST hours).

Travel: Up to 20% travel may be required to our Chicago and Nashville headquarters.

How you will make an impact:
The Project Leader, Clinical Licensure Program for myNexus is responsible for the management of clinical licensing and credentialing process for AIM and myNexus organizations. Responsible for developing project plans and leading small projects to completion.

myNEXUS, a proud member of the Carelon Healthcare Solutions division within Elevance Health, is a fully delegated post-acute benefits management company focused on delivering innovative Home Health and Post-Acute care facility product offerings. We provide comprehensive delegated management services to health plans and other risk-bearing organizations on an at-risk or fee-for-service basis for total medical expense related to Integrated Home Health, Stars Post-Acute care to SNF’s, IRF’s, and LTCHs. Our products include Performance Improvement Program, Social Determinants of Health, Inpatient Avoidance and Clinical Programs.

Primary duties may include, but are not limited to: 

  • Communicates progress, issues, and barriers, to internal and external customers. 

  • Conducts periodic status meetings. 

  • Conducts root cause analysis of processes and issues, identifies and makes recommendations for improvements, and develops documentation. 

  • Researches, compiles, extrapolates and validates data used to forecast staffing needs and work flows, and/or resolve quality and other operational issues. 

  • Assists in managing project scope to ensure business needs are met and the project scope as defined in the project charter is delivered, identifying, documenting and raising requests for changes from original specifications. 

  • Communicate plans, status, and issues within the team, group, or project, including both IT and business members and management. 

  • Has basic understanding of project management methodology, tools & processes and able to apply to small projects.

  • Coordinate all aspects of the clinical licensing and credentialing process for AIM and myNEXUS organizations. 

  • Ensure licensure compliance with State and Federal requirements, accreditation standards, Clinical staff Bylaws, Rules and Regulations and applicable policies and procedures.  

  • Work independently to process, prepare and file new medical license applications and existing medical license renewals on behalf of doctors, nurses, and therapists in accordance with state and federal laws, regulations, and corporate policies.

  • Serve as primary point of contact with vendor to process clinical licensing needs.

  • Review applications, transcripts, and other required confidential documents for completeness and accuracy.

  • Ensure applications are finalized with timeliness and accuracy.

  • Interface with existing licensees and clinical personnel to process all change notifications, including name changes, deaths, address changes of health professionals and additional expansion of licensing needs.

  • Maintain continual and timely communication, including phone calls, emails, certified mailings, faxes, etc. Strong follow-up skills required. 

  • Maintains all existing and new licensee/applicant-related files in accordance with company policies and procedures.

  • Ability to collaborate with people, teams, and varied business partners, teams, and associates. 

  • Responsible for developing project plans and leading projects to completion. 

  • Primary duties may include, but are not limited to: Communicates progress, issues, and barriers, to internal and external customers. 

  • Conducts periodic status meetings. 

  • Conducts root cause analysis of processes and issues, identifies, and makes recommendations for improvements, and develops documentation. 

  • Researches, compiles, extrapolates, and validates data used to forecast staffing needs and workflows, and/or resolve quality and other operational issues. 

  • Assists in managing project scopes to ensure business needs are met and the project scope as defined in the project charter is delivered, identifying, documenting, and raising requests for changes from original specifications. 

  • Communicate plans, status, and issues within the team, group, or project, including both IT and business members and management.


Minimum Requirements:

  • Requires a BA/BS in a related field and minimum of 3 years experience; or any combination of education and experience which would provide an equivalent background.  

Preferred Skills, Capabilities and Experiences:

  • PMI PMP (Project Management Professional)

  • Six Sigma Certification

  • Clinical background

  • Project Leader experience

  • Licentiam experience

  • Basic understanding of project management methodology, tools & processes and able to apply to small projects is strongly preferred.  

  • Strong verbal and written communication skills required. 

  • Previous licensing and credentialing experience preferred.

  • Has strong understanding of project management methodology, tools & processes and able to apply to small projects. 

  • Ability to learn external software applications and internal systems. Thrives with on-the-job training and not afraid to think outside of the box to address challenges in a rapidly growing business environment.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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