Clinical Innovation Specialist

Clinical degree or licensure (OT, PT, or related healthcare credential) 5+ years of clinical experience with demonstrated expertise in home-based care, LTSS populations, or environmental modifications Experience with health plan operations, care management, or utilization management Strong analytical skills with ability to interpret claims data and clinical information Excellent communication skills with ability to translate clinical concepts for diverse stakeholders Experience developing clinical protocols, eligibility criteria, or program frameworks Experience in a startup or high-growth healthcare environment

Apply specialized knowledge of home safety, functional assessment, and environmental risk factors. Conduct data reviews to identify clinical patterns and recommend interventions. Serve as clinical subject matter expert for program development, refinement, and evaluation. Develop and iterate on evidence-based protocols, eligibility criteria, and outcomes frameworks. Partner with data teams to operationalize HIE data access. Develop and maintain risk stratification models and clinical surveillance systems. Produce quarterly risk stratification model updates. Act as clinical voice in partner-facing conversations. Bridge clinical, claims, and program management functions. Provide on-demand clinical expertise for decisions, training, and evaluations. Deliver QBRs with clinical effectiveness evaluation and ROI projections.