Clinical Advisor
Government of Alberta Voir toutes les offres
- Edmonton, AB
- Permanent
- Temps-plein
Job Title: Clinical Advisor
Job Requisition ID: 80485
Ministry: Primary and Preventative Health Services
Location: Edmonton
Full or Part-Time: Full Time
Hours of Work: 36.25 hours per week
Permanent/Temporary: Permanent
Scope: Open Competition
Closing Date: April 23, 2026
Classification: Medical and Health 3
Salary: $3,565.61 to $4,543.11 bi-weekly ($93,062 - $118,575/year)The Ministry of Primary and Preventative Health Services is building a more resilient and sustainable health care system that can support Albertans getting care when and where they need it, while responding to system-wide health challenges, improving health outcomes, and maintaining fiscal responsibility. The ministry supports Albertans' health and well-being throughout their lives by protecting public health and promoting wellness; coordinating and delivering safe, person-centered, quality health services; health system planning and capital infrastructure planning; supporting innovative information management and technologies; regulating health care; and funding the health system.PPHS's Audit and Compliance Assurance Unit (ACAU), in the Financial Reporting Branch, provides compliance monitoring, and performance oversight to improve quality and accountability of health practitioners' claims for benefits under the Alberta Health Care Insurance Plan (AHCIP). ACAU activities include compliance reviews of practitioner claims, audits of entities that exhibit unusual billing patterns, recovery of over-payments, promotion of best practices, supporting criminal investigations, and liaising with departments in PPHS and external regulatory bodies. The majority of health care practitioners under the AHCIP are physicians paid by fee-for-service (FFS). There are approximately 13,000 practitioners enrolled in the plan, providing insured medical services to over 5 million Albertans, with total compensation now averaging over $7.7 billion annually for the 2026-2027 budget.Role ResponsibilitiesThe Clinical Advisor is responsible for applying clinical professional expertise to compliance determinations in the assessment of various compliance reviews and audits regarding AHCIP claims, health services utilization concerns, and suspected inappropriate claim practices.Reporting to the Clinical Supervisor, the Advisor is proficient in written and verbal communications, is able to collaborate and influence staff and stakeholders to achieve positive outcomes.The main responsibilities of the Clinical Advisor are:
- Apply clinical professional expertise to decide on the compliance of health billing events performed by a wide range of practitioners, within the regulatory application of the AHCIP and related authorities.
- Provide clinical interpretations and advice to other team members, namely: auditors within the unit, the data analytics team, other branches/divisions within the Ministry, as well as internal legal counsel, and the Health Investigations Unit (HIU) of Service Alberta in criminal cases.
- Provide clinical interpretations and advice to influence the behavior of multiple external stakeholders such as the practitioner and their staff that are subjects of the reviews and audits, the Alberta Medical Association (AMA) and the College of Physician and Surgeons (CPSA). As an example, educating providers and their employees about acceptable claim practices and utilization rates to proactively encourage compliance.
- Collaborate with other team members and staff in completing ACAU compliance reviews and audits with the understanding of how the clinical review work relates to others in impacting the health system in terms of financial recoveries, cost savings, and compliance to legislation.
- Identify and escalate issues related to billing rules and/or practices in need of change, such as where rules are unclear, misinterpreted, or abused.
- Manage multiple compliance reviews concurrently, as well as audits, special projects, and contributions of advice to others on clinical matters.
- Apply creative problem-solving skills to plan approaches for compliance reviews and audits that involve understanding new areas where ACAU has no prior history. For example, compliance reviews extend beyond General Physicians to encompass roles where billing risks have increased, such as Radiologists, Psychiatry, and Ophthalmologists, as well as clinics involving multiple practitioners and new business models (i.e. Private Member Clinics).
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- Build Collaborative Environments: Facilitates open communication and leverages team skills.
- Systems Thinking: Considers inter-relationships and emerging trends to attain goals.
- Agility: Identifies and manages required change and the associated risks.
- Bachelor's degree in nursing and three (3) years of related experience.
- Must be a regulated member of the Collage of Registered Nurses of Alberta (CRNA)
- Experience using MS Word, MS Excel and Adobe PDF with proficiency is required.
- Experience carrying out compliance reviews is required.
- Clinical experience with practice guidelines, patients-case documentation.
- Processes, medical terminology and medical and surgical procedures.
- Experience reviewing and analyzing various medical documents and reports.
- Knowledge of current information issues, trends, research and technologies within public health.
- Experience with Schedule of Medical Benefits, Allied Health Practitioners' schedule of benefits and the Alberta Health Care Insurance Act.
7.25 hours daily / 36.25 hours weekly, Monday to FridayLocation:
ATB Place North, 10025 Jasper Avenue, Edmonton, AB.
- Final candidates may be required to undergo a security screening.
- Any costs associated with obtaining the required documents/checks as noted or interview travel expenses, will be the responsibility of the candidate. Out-of-province applicants can obtain the required documents/checks from the province they currently reside in.
- Working for the Alberta Public Service - .
- Public Service Pension Plan (PSPP) - .
- Management Employees Pension Plan (MEPP) - .
- Alberta Public Service Benefit Information - .
- Professional learning and development - .
- Research Alberta Public Service Careers tool - .
- Positive workplace culture and work-life balance.
- Leadership and mentorship programs.
Applicants are advised to provide information that clearly and concisely demonstrates how their qualifications meet the advertised requirements, including education, experience, and relevant examples of required competencies.Candidates are required to apply for a job online. Please visit for more information. Please visit , for more information.In your resume, please include dates (including months and years) associated with all education and work experience. For example, January 2006 - June 2009 (part-time). This example is provided for illustrative purposes only. Applicants are encouraged to present their information clearly and thoroughly, using a format that best conveys their experience.It is recommended applicants who have completed post-secondary studies from outside of Canada obtain an evaluation of their credentials from the International Qualifications Assessment Service (IQAS)( ) or from a recognized Canadian Credential Evaluator; please visit the Alliance of Credential Evaluation Services of Canada for more information ( ).It is recommended that applicants include the assessment certificate from IQAS or any other educational assessment service as part of their application.Closing Statement
This competition may be used to fill future vacancies, across the Government of Alberta, at the same or lower classification level.We thank all applicants for their interest. All applications will be reviewed to determine which candidates' qualifications most closely match the advertised requirements. Only individuals selected for interviews will be contacted.If you require any further information on this job posting or require an accommodation during the recruitment process, please contact Jagreet Uppal at .