Note: The job is a remote job and is open to candidates in USA. ZeOmega is a company focused on healthcare solutions, and they are seeking a Clinical and Regulatory Program Consultant to work collaboratively with implementation and support teams. This role involves ensuring client business and clinical requirements are met, serving as a subject matter expert on clinical best practices and regulatory compliance, and enhancing the end-user experience.

Responsibilities

• Ensure client business and clinical requirements are accurately captured and addressed throughout the implementation process and beyond
• Serve as a subject matter expert on clinical best practices and health plan regulatory compliance
• Ensure that ZeOmega’s solutions align with industry standards and meet client needs
• Focus on enhancing the end-user experience by promoting usability and workflow efficiency

Skills

• Strong industry knowledge of California regulations and health plan experience
• Minimum of 3 years of clinical experience, preferably within a managed care or health plan setting
• Strong working knowledge of DHCS regulations, Medi-Cal program policy, and California state healthcare compliance requirements
• Familiarity with DHCS All Plan Letters (APLs), Medi-Cal Managed Care contracts, and related reporting requirements
• Demonstrated experience working with health plans, including utilization management, case management, or care coordination
• Familiarity with healthcare IT platforms and population health management solutions
• Ability to manage multiple projects and meet deadlines in a fast-paced environment
• Expertise in clinical best practices and regulatory compliance for health plans
• Excellent communication and presentation skills
• Ability to analyze business requirements and translate them into solution design
• Current and unrestricted US LPN or RN license required
• Prior experience in consulting or implementation of healthcare technology solutions is a plus

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