Humana Sr. Clinical Strategy Consultant - Work at Home in Overland Park, Kansas
The Senior Clinical Business Professional assists in the development and stabilization strategy of all Care Management program activities in all existing, new and expansion markets. This role will assist in identifying areas of operational development and performance improvement in existing programs related to, nurse case management, integrated behavioral health, pharmacist, and social services support.
Be a part of the Care Delivery Organization (CDO) CenterWell and Conviva, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout the country.
Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At CenterWell and Conviva, a division of Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At the CDO, we're seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
Humana's Care Delivery Organization is seeking a Sr. Clinical Practice Strategy Consultant to be on the national leadership team. This role assists in the development and stabilization strategy of all Care Management program activities in all existing, new and expansion markets. This role will assist in identifying areas of operational development and performance improvement in existing programs related to, nurse care management, integrated behavioral health, pharmacist, and social services support. The main responsibilities of the role are:
Develop a comprehensive knowledge of Humana's Care Delivery Organization strategy, best practices and tools
Identify process improvement opportunities and assist in development and implementation of the solutions
Assist with identifying opportunities for automation, analytics, and services to improve and support program production, quality and financial targets
Assist in design and implementation of clinic workflows, processes, and standard operating procedures
Assist in development and reporting of operational metrics to ensure adherence to clinic strategy and operational efficiencies
Assist with developing, implementing and managing team workflows / program training materials
Will train all new market ancillary resources and ensure that local market trainers are proficient to train on all required elements
Assist in proactively obtaining feedback and adjusting training and materials based on operational needs, gaining optimization, to obtain desired productivity and clinical outcomes for all care management programs
Assist in researching and the development of clinical practice guidelines and to ensure operational workflows alignment with those guidelines
Participate and coordinate with technology team to ensure technology supports workflows
Assist in development and coordination with analytics team to develop productivity dashboards and metrics
Assist with implementing and managing quality checks and auditing of workflow and clinical documentation for process improvement purposes
Coordinates in a matrixed reporting structure to complete job tasks
Collaborates w/ various levels of team members and leaders across the organization to improve clinic operational effectiveness
Assist with developing and implementing policy and procedures required to ensure operational stabilization and compliance with all federal, state, and local requirements
Assists with utilizes data analytics to target development and implementation of clinical program goals and processes to ensure overall success
Experience in healthcare field
Strong program and project management skills
Proven record and experience to facilitate groups to achieve performance objectives
Takes initiative and able and willing to work autonomously
Health solutions system experience in the areas of Population Health Management and/or care management.
Ability to manage competing priorities and escalate when appropriate while working in a fast paced environment with changing priorities
Ability to identify gaps and/or opportunities for improvement in existing processes or can develop new ones as a result.
Broad understanding of integrated team based models and programs in a primary care setting
Ability to promote collaboration among inter-dependent functions as a fundamental tenet of the Humana culture, and critical to the success of our business strategy
Effectively meet and exceed customer needs; build productive relationships with physicians, internal customers, and takes responsibility for customer loyalty and satisfaction
Work effectively and cooperatively with other members of the CDO Team; establishing and maintaining good working relationships. Must have strong team orientation and collaboration. Seek to achieve common goals that contribute to the overall success of the organization.
Demonstrate interpersonal/verbal communication skills
Deliver well-prepared training that engages participants, uses active listening skills, demonstrates organization, and continually analyzes and improves all aspects of delivery and content.
Comprehensive knowledge of Microsoft Office applications, including PowerPoint, Excel and Access
Ability to travel up to 50%
Clinical related degree or healthcare related field
Experience with training/onboarding development and execution
Experience developing and/or utilizing data for performance and operational metrics
Experience with EMRs, CRM software, specifically Salesforce, and large scale implementations across multiple locations.
Broad provider-centric business experience in a variety of clinical operating environments (physician practices, clinics, groups) with exposure to different clinical models (Staff, IPA, PHO, Home-based, etc.)
Prior experience within a managed care environment, and experience with multiple products (Medicare, Medicaid Duals, Commercial Group/Individual) is strongly desired
Scheduled Weekly Hours