Analyst, Clinical Consulting (RN/BSN/PA)) (Finance)
For nearly 80 years, Segal has been providing employee benefits, retirement plan investment advisory and human resources consulting for multiemployer trust funds, corporations and public sector organizations. Segal is an independent, privately and employee-owned firm. Our independence allows us to provide unbiased consulting services for our clients. Headquartered in New York City, Segal has offices throughout the United States and in Canada. We are a smaller organization that provides a more intense and broader exposure for development purposes within a culture that is highly collegial and team-oriented. You will work with colleagues who are smart, professional, talented and...nice people. We offer a competitive pay and benefits package that includes a defined benefit and matching 401(k) retirement plans.
Are you passionate about delivering trusted advice that improves lives?
Does utilizing your nursing credentials to consult with clients and potentially positively impact thousands of lives inspire you?
Come work with us!
Our Analyst, Clinical Consulting will have the opportunity to be a key contributor to analyzing benefits claims experience, client-based products and services to enhance clinical consulting capabilities, deliverables and services.
Key Responsibilities:
• Contribute to health care clinical consulting projects by applying technical expertise reflective of and customized to client needs/issues and objectives
• Perform data analysis and technical review of health benefits claims activities, contracts, financial arrangements and program effectiveness
• Collaborate with colleagues to help clients to maximize the value of the healthcare spending, participate in client projects and service delivery initiatives (e.g., proposals, clinical reviews, negotiations, contract reviews, etc.)
• Assist with designing and implementing onsite health optimization projects (e.g., onsite clinics) including analyzing the effectiveness and efficiency
• Assist with conducting and reporting on clinical audits of disease management programs
• Support clinical consulting initiatives and innovations to the Practice and contribute to the revenue generating capabilities of the Company
• RN, BSN, PA designation or other clinical background required
• 1 to 3 years of clinical experience within a health benefits or health benefits consulting and/or related professional consulting firm or in a corporate environment providing technical review and analysis of data, contracts, financial arrangements and program effectiveness is highly preferred.
• Basic SQL coding, Python knowledge or other large data set manipulation experience is a plus. Advanced knowledge of Microsoft products such as Excel, Word and PowerPoint is required.
• Knowledge of providers, products, services, financial, data reporting, contracting and negotiating elements and processes is preferred.
• Experience with pre-certifications, medical records review and coordination of claims appeals resolution is preferred
• Knowledge of HIPAA, COBRA, Health Reform, Medicare and Mental Health Parity Laws
• Knowledge of patient cost-sharing, deductibles, copays, coinsurance and out of pocket limits
• Strong technical/analytical and problem-solving skills; strong organizational and detail skills; effective communicator (oral/written) and relationship building skills required to work effectively with teams
• Demonstrated project management and multi-tasking abilities with the curiosity and aptitude to stay current as trends and technologies change
• Previous internships in industry and knowledge of industry a plus
About Segal and its Total Rewards Program:
Segal is a privately owned, leading North American employee benefit, human resources, and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segal's total rewards are part of what makes Segal a special place to work. The current salary range for this position is $62,500 to $75,000 plus opportunity for a discretionary performance bonus based on company profitability and employee performance. In addition, Segal offers a comprehensive suite of benefits to include a non-contributory defined benefit pension plan, matching and discretionary contributions to a 401(k) profit sharing plan, medical and prescription benefits including contributions to a health savings account for eligible employees, dental benefits, life insurance, disability insurance, an Employee Assistance Program, wellness benefit reimbursements and rewards, and professional credential and tuition reimbursement. Segal also provides comprehensive paid time off including holidays, vacation days, sick leave, paid family leave and sabbaticals.
Please Apply:
Segal is the right size, the right organization and…the right move for you! Please apply now.
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