CARE CONSULTANT JOB DESCRIPTION

A Care Consultant advises providers, patients, and health plan clients on how to improve care outcomes and manage costs. In managed care settings, this role spans Medicare, Medicaid, and commercial lines of business, each with distinct reimbursement structures and compliance requirements. Meaningful work here. The consultant translates population-level data into provider-specific action plans, influencing how value-based contracts perform and how patients with chronic conditions are managed across ambulatory and community settings.

As the Care Consultant, you translate clinical and utilization data into actionable recommendations that improve health outcomes and reduce unnecessary care costs within managed care and provider-facing programs. You operate across an assigned provider panel or client portfolio, partnering with account managers, clinical subject matter experts, and practice teams to execute on quality improvement and cost management objectives.

Career Impact: Developing expertise in value-based payment models and population health metrics positions you for advancement into senior consulting, clinical program leadership, or managed care strategy roles.

Business Impact: Providers and health plan clients rely on your assessments to close care gaps, improve quality scores, and meet cost targets tied directly to contract performance.

Growth Opportunity: Exposure to multiple lines of business, including Medicare, Medicaid, and commercial programs, expands your technical range and opens pathways to program director and account leadership roles.

• Consult with provider practices on care delivery improvements that reduce cost and improve patient outcomes under value-based contracts.
• Analyze quality metrics and utilization reports to identify care gaps and develop provider-specific action plans.
• Collaborate with account managers and clinical subject matter experts to support implementation of care management programs.
• Conduct practice assessments and provide recommendations for care coordination, care management workflows, and patient-centered delivery models.
• Develop and deliver educational programs for providers and practice staff on quality metrics, data review, and program requirements.
• Present program performance reports and analytical findings to provider leadership and internal stakeholders.
• Track progress against cost, quality, and utilization targets and prepare status updates for management review.
• Support implementation of chronic disease care pathways and community-based interventions across assigned populations.

• Bachelor's degree in health care administration, nursing, public health, or a related field, or equivalent work experience.
• 5 or more years of health care experience, with direct involvement in managed care, clinical consulting, or provider-facing roles.
• Working knowledge of Medicare, Medicaid, and commercial lines of business and the regulatory frameworks governing each.
• Demonstrated ability to analyze clinical and utilization data and translate findings into actionable recommendations.
• Experience supporting or leading quality improvement initiatives in ambulatory, community, or managed care settings.
• Strong verbal and written communication skills, with the ability to present complex information to clinical and administrative audiences.
• Ability to manage multiple provider accounts or client engagements concurrently, meeting deadlines and performance targets.

• Advanced degree such as an MPH, MBA, or MSN, or an RN or other clinical licensure.
• Prior experience with value-based payment models, population health management, or practice transformation programs.
• Familiarity with electronic health record environments and quality reporting frameworks used in provider settings.
• Experience working in or consulting to large, complex employer groups or multi-line health plan environments.

• Provider quality score improvement rate, measuring progress on contracted metrics across the assigned panel.
• Care gap closure rate per provider, tracking the share of identified gaps addressed within reporting periods.
• Cost of care variance against targets, reflecting how managed accounts perform relative to plan benchmarks.
• Program engagement rate, measured by the proportion of assigned providers actively participating in care management activities.
• Status report on-time delivery rate, reflecting reliability of performance tracking and management communication.
• Typical tools: Care management platforms (commonly population health management or case management applications); productivity and reporting tools (commonly spreadsheet and presentation software).

• Base Salary Range: $75,000 to $105,000 annually, depending on seniority and line of business scope
• Bonus: Annual performance-based bonus, typically 5% to 10% of base salary
• Equity: Generally not offered at this level; varies by employer type
• Health Benefits: Medical, dental, and vision coverage, typically effective on first day or within 30 days
• PTO: 15 to 20 days annually, plus paid holidays; telecommute eligibility common at senior levels
• Common Perks: Continuing education support, professional development stipend, mileage or travel reimbursement for provider visits

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Employment with any organization using this template is contingent on successful completion of a background check, which may include verification of prior employment, education, and criminal history consistent with applicable law. All qualified applicants will be considered without regard to race, color, religion, sex, national origin, disability, age, or any other protected class under federal, state, and local law. Reasonable accommodations are available to individuals with disabilities throughout the hiring process and in the performance of essential job functions upon request. Candidates must be authorized to work in the United States.

The Care Consultant delivers coordinated care services by rostering staff, managing client enquiries, and driving new business development within a home care branch. Working alongside the Live-in Care team and branch establishment teams, this role shapes safe, compliant service delivery that meets CQC standards and achieves growth targets.

Key Responsibilities

• Be the first point of contact for both new and existing clients and Care Workers.
• Handle initial enquiries from prospective clients and their families.
• Roster staff to provide a safe delivery of service to clients.
• Liaise with other professionals involved in clients' care.
• Assist with recruiting new care workers to the team.
• Monitor care workers and carry out supervisions and appraisals.
• Support the effective handling of safeguarding, incidents, and complaints as required.
• Ensure the service is working within the standards expected by the CQC.
• Work alongside the Care at Home business development to network and drive new business.
• Work closely with the Live-in Care team to co-ordinate the set up of any Live-in packages for your area.
• Work to specific targets and key performance indicators in order to develop the service.
• Work in liaison with the existing establishment teams in the branches.

Required Qualifications

• Related work experience required.
• Excellent communicator with the ability to build and maintain strong relationships.
• Flexible to cope with changing demands and priorities, remaining calm under pressure.
• Well organised with the ability to multitask.
• Friendly, confident and helpful telephone manner.
• Strong focus on teamwork with the ability to work independently and apply initiative.
• Positive, focused attitude to enable targets to be met and exceeded.
• Must hold a valid driver's licence.

Embedded within the Programmed Care team, the Care Consultant builds and sustains relationships with aged care clients and their families to deliver reliable, high-quality in-home care. Working closely with the Programmed Care Manager, this role owns client care coordination and budget support to achieve strong supply teams and positive client outcomes.

Core Functions

• Provide high-quality customer service to support aged care clients receiving direct care in their homes.
• Provide ongoing support to direct care clients to help them achieve their goals.
• Co-ordinate client care and assist with budget management.
• Work directly with the Programmed Care team to develop relationships with clients and families to deliver strong supply teams.
• Work directly with the Programmed Care Manager to build and supply reliable high-quality care teams to meet clients' clinical needs, preferences, and personal goals.
• Respond to all client needs with a sense of urgency to provide quality outcomes.
• Record, maintain and action area handovers.

Qualifications & Experience

• Strong background in client relationship management.
• Strong understanding of the Aged Care Quality Standards.
• Proven experience in a similar role within the Community, Aged or Disability Care environment.
• High level of communication skills with a commitment to care and empathy for clients and staff.
• Strong organisational and time management skills.
• Outstanding attention to detail.

Reporting to senior engagement leadership, the Health Care Consultant delivers analytical reviews and policy summaries in support of health care delivery system reform contracts. Partnering with cross-functional project teams, this role shapes the quality and integrity of Medicaid and Medicare programme reporting that informs client decision-making.

Primary Duties

• Independently perform analyses and reviews relating to health care delivery system reform engagements.
• Review, summarise, and apply Federal and State Medicaid and/or Medicare policies and regulations.
• Support preparation of analytical data reports and presentations.
• Support implementation of quality improvement concepts and methods.
• Manage industry inquiries and communications related to contract engagement activities.
• Maintain security and confidentiality of all protected health information.

Skills & Qualifications

• High school diploma or GED required; with a Bachelor's degree in economics, mathematics, finance, health care, or related field preferred.
• Internship or 1 year of healthcare experience required.
• Proficient in Microsoft Excel, Access, Word, and other applicable software.
• Strong ability to analyse data to identify issues, manage multiple deadlines, and prioritise assignments.
• Organised and detail-oriented with strong problem-solving skills.
• Demonstrated ability to communicate verbally and in writing, and to multitask with planning and efficiency.
• Ability to work in a team environment and travel based on client and business need.

Sitting at the intersection of professional healthcare relationships and commercial sales strategy, the Oral Care Consultant manages key dental accounts and delivers budgeted growth targets through consultative selling and NPD launches. Operating across dentists, hygienists, therapists, and distributor networks within an assigned territory, this role builds the scientific credibility and market presence of a professional oral care portfolio.

Duties

• Manage key dental accounts and monitor sales performance.
• Implement specific brand sales strategies for the channel as directed by the Sales Manager.
• Deliver budgeted sales and growth targets through active account management, analysis of sales information, and successful NPD launches.
• Monitor, develop and maintain broad distribution of a professional oral care range of products within the assigned territory.
• Provide the NSM with market insights and feedback from the profession.
• Develop effective professional relationships with dentists, therapists, hygienists, OHTs, dental assistants and distributors.
• Attend and participate in industry conferences as required.
• Promote oral care products through consultative selling, highlighting features, benefits, and pertinent selling points.
• Enhance the company's image as a leading scientific and technology expert in Oral Care using APEX Skills.
• Drive awareness of recommendations for the oral care range and conduct market research and new product testing where appropriate.
• Input field data into the professional oral care database.

Requirements

• Dental Hygienist, OHT, or Sales background with a minimum of 2 years of sales or customer development experience.
• Experience working in professional or consumer product goods preferred.
• Passion for data and analytics with the ability to tell stories based on insights.
• Collaborator by nature with a growth mindset, high curiosity, and ability to connect the dots.
• Proficient in English and local language.
• Skilled in Google Suite including Sheets, Slides, and Docs.
• Comfortable working in a fast-paced environment and managing ambiguity.

A key member of the provider enablement and Account Management team, the Senior Care Consultant leads consulting engagements with physician practices participating in alternative payment models across Medicare, Medicaid, and Commercial lines of business. Collaborating across clinical subject matter experts and internal departments, this role delivers provider-specific action plans and quality improvement strategies that reduce cost and improve patient outcomes.

Functions

• Exhibit experienced consulting competencies to drive recommendations and actions with providers and practice teams on care delivery interventions that result in cost savings and improved patient outcomes.
• Collaborate with the Account Manager, provider enablement, and other internal departments to collectively support the provider in their value-based contract.
• Develop and execute provider-specific action plans based on assessed opportunities.
• Obtain and analyse quality metrics and reports to support care coordination, identify improvement plans, and contribute to community learning forum design and implementation.
• Conduct assessments and provide recommendations for provider enablement opportunities.
• Promote practice transformation to team-based, patient-centred care delivery.
• Provide education for practices to develop expertise with metrics and data review for quality improvement.
• Track programme progress and prepare status reports for management or senior management.
• Interact with and lead large meetings with practice staff including physicians and clinical and administrative staff.

Experience & Qualifications

• Bachelor's degree required.
• 5 years of health care experience or equivalent combination of education and experience.
• Experience in physician practice transformation, quality improvement, ambulatory care metrics, and electronic health records preferred.
• Previous experience across multiple lines of business including Medicaid, Medicare, and Commercial preferred.
• Understanding of value-based payment models, population management, and care delivery concepts.
• Strong financial analysis skills.
• Proficient in presenting technical and strategic information to multiple levels of stakeholders, with excellent communication skills.
• Self-motivated, organised, and able to balance big-picture goals with attention to detail.
• Local travel may be required.

Sustained performance in complex care management programmes depends on the Senior Care Consultant, who develops strategic visions for large employer accounts and leads implementation and execution of care management products across managed care, wellness, and value-based programmes. Serving as a subject matter expert embedded within UMR's client services structure, this role enables measurable improvements in plan performance and client satisfaction for the organisation's highest-profile accounts.

Accountabilities

• Develop and maintain a care management strategic vision for each customer, tracking activity through a business plan and providing monthly updates to leadership.
• Develop and enhance business relationships with customers, internal teams, service vendors, and partners to ensure availability of comprehensive care management products.
• Educate and assist others on the competitive advantage, requirements, value, and expected service levels of products.
• Serve as subject matter expert for all Care Management products and services, taking ownership of CMS programme implementation and execution.
• Engage in the implementation process for new customers, including internal strategy meetings with top accounts and leadership.
• Present Care Management reporting with analytical support and strategic direction based on population, client targets, plan performance, and trend analysis.

Position Requirements

• Bachelor's degree required; with Master's or RN degree preferred.
• 10 or more years of experience working directly with customers, providers, or in a health care setting.
• Customer relationship experience, preferably with complex or large groups.
• Knowledge of managed care, wellness programmes, and group health delivery systems.
• Ability to work independently while handling multiple tasks, prioritising, planning, and managing work effectively.
• Excellent verbal, presentation, and written communication skills with the ability to work across all levels internally and externally.
• Willingness and ability to travel.

As the Integrated Care Consultant, this role leads the development of preventive and rehabilitation medicine pathways, providing evidence-based care across musculoskeletal, cardiovascular, and metabolic health in a multidisciplinary ambulatory setting. The Vhi Health and Wellness team relies on this work to advance integrated chronic disease management, drive innovation in disease prevention, and deliver improved outcomes for patients across community and tertiary care environments.

Activities

• Provide a holistic, multidisciplinary approach to the care of customers seeking to optimise health and well-being or address chronic disease needs.
• Provide evidence-based chronic disease care in musculoskeletal, bone, brain, cardiovascular, and metabolic health.
• Assess and manage patients with complex symptoms in the community, liaising with other medical specialties where appropriate.
• Engage with consultant and primary care colleagues within the network and 360 Centre to provide enhanced ambulatory community care.
• Develop patient pathways with an integrated approach across Health and Wellness services including screening, urgent care, and hospital at home.
• Lead development of clear pathways, referral modes, ambulatory care models, and third-party hospital relationships to support continuity and outcome-based care.
• Develop case-finding mechanisms for individuals with undiagnosed chronic disease and promote disease prevention measures.
• Lead development of educational programmes for patients and staff to support the integrated care agenda.

Knowledge, Skills & Abilities

• Minimum 5 years of relevant clinical experience with registration on the specialist register of the Irish Medical Council or eligibility for the same.
• Postgraduate training in Musculoskeletal, Exercise, Rehabilitation, Lifestyle, Cardiovascular, or Metabolic Medicine.
• Fellowship or eligibility for Fellowship of the Royal College of Physicians UK or Ireland, with PhD or DPhil in clinical medicine desirable.
• Experience in clinical leadership, service strategy development, ambulatory and community-based care, and leading multi-professional teams.
• Expertise in diagnostic physiology, including physical functional assessment, vascular assessments, cardiopulmonary exercise testing, and assessment of adiposity and metabolic function.
• Expertise in diagnostic imaging with postgraduate qualifications, preferably in ultrasound and diagnostic MRI.
• Experienced clinician with evidence of developing, applying, and reviewing evidence-based approaches to decision-making and early adoption of health care innovation.
• Experience of delivery and development of community and ambulatory care, including developing patient pathways from community to tertiary care.
• Good verbal and written communication skills with strong planning, organising, and data interpretation abilities.
• Committed to fostering partnerships and multi-disciplinary relationships.