Description The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise. The Clinical Strategy and Practice Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The Clinical Strategy and Practice Lead + Develop an overview of current member and physician engagement strategies and models, and work with the Clinical teams to create a core national approach that aligns with Humanas brand, commitment to quality outcomes and related market strategies. + Develop educational resources and executive presentations to address organizations need to understand the challenges and opportunities for member/physician engagement + Design and create implementation guides for programs, with a focus on; consistent program implementation, alignment of reporting metrics, improved engagement rates and improved member outcomes. + Develop national administrative processes and guidelines for beneficiaries in Medicaid Managed Care, Long Term Services and Supports, and Dual Demonstration programs that meet or exceed state and CMS contract requirements. + Maintain on-going relationships with strategic partners and vendors and serve as the key contact for the resolution of identified program issues. + Develop program governance and reporting requirements to monitor program effectiveness and maintain current evidence based practices. Required Qualifications + Bachelor's degree in healthcare or related field + Registered Nurse or Licensed Social Worker + 3 years experience working with Medicaid and/or Medicaid-Medicare members; member clinical/program engagement, member communications, member education/training, and/or member outcome tracking and monitoring + 2 years experience interpreting dashboards and data visualizations for clinical program development strategy + Knowledge of principles and practices regarding member and/or provider engagement models and/or service delivery systems + Proficiency in Microsoft applications (Word, Outlook, One Note, Power Point, Excel) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications: + Masters Degree in related field (MBA, MPH, MA, etc.) + CCM, CPHQ, CMCN, Green Belt or equivalent certification or licensure + Experience working with persons receiving long-term care and/or home and community based services and/or work experience in managed and/or long-term care settings working with Medicaid and/or Medicaid/Medicare eligible populations + Previous experience working for a managed care organization + 2 years of project leadership or supervisory experience + Previous experience working with healthcare providers (education, engagement strategy, and/or member outcome tracking/monitoring) Additional Information This position is work at home and could require up to 50% travel. Must have accessibility to high speed DSL or cable modem for a home office (satellite internet service is NOT allowed for this role); and a minimum internet connection speed of 10M x 1M Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isnt missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. California Residents If you are a California resident and would like to review our California Consumer Privacy Act (CCPA) Policy click here: CA Resident Privacy Policy <>
Categories
• Financial Services