Clinical Innovation Specialist

Description

• Develop and maintain risk stratification models and clinical surveillance systems for proactive member identification
• Apply specialized knowledge of home safety, functional assessment, and environmental risk factors to identify members who would benefit from Jukebox programs
• Deliver QBRs with clinical effectiveness evaluation, evidence-based protocol modifications, and ROI projections
• Act as clinical voice in partner-facing conversations
• Conduct data reviews to identify clinical patterns suggesting environmental modification needs and DME recommendations that could prevent claim progression
• Bridge clinical, claims, and program management functions, translating clinical complexity into operational decisions
• Produce quarterly risk stratification model updates incorporating latest HIE data feeds, rolling average risk scores, predictive analytics, and model performance validation
• Partner with client and internal data teams to operationalize HIE data access
• Develop and iterate on evidence-based protocols, eligibility criteria, and outcomes frameworks informed by Jukebox's cross-client experience
• Serve as clinical subject matter expert for program development, refinement, and evaluation
• Provide on-demand clinical expertise for time-sensitive decisions, protocol development, staff training, and vendor evaluations
• Participate in Joint Operating Committee meetings with prepared analysis including member health trends, risk trajectory reporting, program performance metrics, and optimization opportunities

Requirements

• Background in risk stratification, predictive modeling, or population health analytics
• Excellent communication skills with ability to translate clinical concepts for diverse stakeholders
• Knowledge of home modification interventions, DME, or accessibility solutions
• Experience with health plan operations, care management, or utilization management
• Frequent team off-sites and get-togethers around the country
• Experience working with Medicaid managed care organizations or MLTSS programs
• Experience with Health Information Exchange (HIE) systems and/or claims data and data integration
• 5+ years of clinical experience with demonstrated expertise in home-based care, LTSS populations, or environmental modifications
• Experience developing clinical protocols, eligibility criteria, or program frameworks
• Familiarity with value-based care models and outcomes measurement
• Experience in a startup or high-growth healthcare environment
• Strong analytical skills with ability to interpret claims data and clinical information
• Clinical degree or licensure (OT, PT, or related healthcare credential)

Benefits

• Collaborative team environment
• Hospital Insurance
• Unlimited PTO + 10 paid holidays
• A laptop and company swag upon hire
• HSA plan with company seeding
• High trust environment
• Yearly wellness stipend
• $1000 stipend towards work from home costs
• Generous company-funding of our health, vision, and dental plans
• Short and Long-Term Disability
• 401k immediately upon hire
• Generous candidate referral program
• Life and Personal Accident Insurance
• Monthly Townhalls

Training + Development

Interview process

Visa Sponsorship

Security clearance