Description
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.
Job Description
The Clinical Writer/Case Management Product Manager is responsible for development of proprietary clinical guidelines by researching, compiling, organizing and interpreting technical medical information and clinical trial data. Will be presenting that information in a clear format for internal and external medical professional and claim administrator users. Also, responsible for rating clinical trial and study content for strength of evidence.
Roles and Responsibilities
- Clinical writers will work directly with contract and internal physician reviewers during the guideline development and updating process.
- Serve as the liaisons between these reviewers, present content updates to the Guideline Quality Review Committee and assist document approvers to provide electronic approval signatures.
- Research, development and analysis of Case Management and Utilization Review Quality Improvement projects.
- Conduct Case Management and Utilization Review Audits as assigned.Development of continuing education programs for professional staff.
- Research and maintain State Workers’ Compensation Guidelines and Laws; assist in maintenance of Case Management and Utilization Review Law databases.
- Perform other functions as requested to reach GENEX goals.
- Coordinate ongoing education programs for GENEX case management staff.
- Serves on the Field Case Management and Utilization Management Quality Assurance.
Qualifications
- Minimum Education: Diploma, A.S. degree or B.S. degree in nursing required.
- Required Licenses: Registered Nurse and Certified Case Manager (CCM).
- Required Skills and Experience: Minimum 5 years of recent clinical nursing, case management experience and/or clinical guideline development experience. Workers’ Compensation experience preferred. Utilization management experience preferred. Knowledge of ACOEM strength-of-evidence rating/scoring system a plus.
Desired Skills and Experience
- Must have strong analytical and research skills including experience with medical journals, technical reports, electronic media and health care-related textbooks.
- Ability to interpret and organize scientific/medical data content.
- Possess excellent writing skills and attention to writing detail (style/consistency, grammar, syntax, scientific accuracy, and layout).
- Strong presentation skills.
- Ability to set priorities and meet deadlines is essential.
- Excellent organizational skills.
- Ability to work independently and on a project team.
- Must be proficient in Microsoft Office suite programs such as Word and Excel as well as experience with internet searches and a comfort level with other software programs.
- Clinical writers must have a general understanding of relevant industry guidelines.
