Clinical Advisor

Job Description

Job Description

We are seeking a Clinical Advisor to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Clinical Advisor plays a critical role in enhancing the quality and efficiency of healthcare delivery within the organization. This position focuses on evaluating clinical practices, identifying opportunities for improvement, and collaborating with healthcare providers to implement evidence-based strategies that optimize patient outcomes. The advisor serves as a clinical expert and liaison between healthcare teams and administrative leadership, ensuring compliance with regulatory standards and organizational goals. Through data analysis and performance monitoring, the RN Advisor drives continuous quality improvement initiatives that support patient safety and satisfaction. Ultimately, this role contributes to the advancement of healthcare excellence by fostering a culture of accountability, education, and innovation across provider networks.

Minimum Qualifications:

• Current and unrestricted Registered Nurse (RN) license in the State of Florida.
• Bachelor of Science in Nursing (BSN) degree or equivalent.
• Minimum of 3 years of clinical nursing experience in a healthcare operations, provider relations, quality improvement, managed care, care coordination, MSO operations, provider engagement or related healthcare functions. 
• Demonstrated knowledge of healthcare quality improvement methodologies and performance measurement.
• Proficiency in analyzing clinical data and generating actionable insights.

Preferred Qualifications:

• Master’s degree in Nursing, Healthcare Administration, or a related field.
• Certification in quality improvement or patient safety (e.g., CPHQ, CPPS).
• Experience working within managed care or health plan environments.
• Strong familiarity with healthcare regulatory standards such as CMS, Joint Commission, or NCQA.
• Advanced skills in data analytics software and electronic health record (EHR) systems.

Responsibilities:

• Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
• Conduct comprehensive reviews of healthcare provider performance metrics and clinical outcomes to identify areas for improvement.
• Collaborate with multidisciplinary teams to develop and implement quality improvement plans and best practice guidelines.
• Provide expert clinical consultation and education to healthcare providers to enhance adherence to evidence-based care standards.
• Monitor compliance with regulatory requirements and internal policies related to patient care and safety.
• Analyze healthcare data to generate reports and recommendations that inform leadership decision-making and strategic planning.
• Facilitate communication between clinical staff and administrative departments to support coordinated care delivery.
• Participate in the development and delivery of training programs aimed at improving clinical competencies and provider performance.
• Support initiatives that promote patient-centered care and optimize resource utilization within the healthcare system.
• Performs other duties as assigned.