Clinical Advisor (RN)
Lumen Solutions Group Inc.
Clinical Advisor (RN)
This role is for a Registered Nurse with strong analytical skills who can review and interpret clinical and population health data. The nurse will analyze high-cost claims, healthcare utilization patterns, and clinical information to help the organization identify trends, improve health outcomes, and control healthcare costs.
It is an internal, non-patient facing role focused on clinical data analysis and reporting rather than bedside care.
Responsibilities
- Analyze high-cost claimant and population health data.
- Review clinical, financial, and utilization data across systems.
- Identify care gaps, trends, and cost-containment opportunities.
- Translate clinical findings into clear reports and slide presentations.
- Support healthcare analytics and reporting requests.
- Collaborate with internal teams to improve health outcomes and cost management.
Requirements
- Active Registered Nurse (RN) License (state or compact).
- 4+ years clinical nursing experience.
- 2+ years healthcare data analytics experience.
- Strong knowledge of medical terminology and healthcare utilization review.
- Advanced skills in Excel, PowerPoint, and data interpretation.
- Bachelor's degree required.
Preferred
- Experience in health plans / insurance environment.
- Graduate degree such as MSN, MPH, or MBA.
Vacancy posted 5 days ago
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