Senior Clinical Strategy Consultant- CenterWell- Remote

Profile

Description

The Senior Clinical Business Professional leads teams of nurses and behavior health professionals responsible for care management. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

Be a part of the Primary Care Organization (PCO) for 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 PCO, 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 Primary Care 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 training, quality auditing, program development and performance improvement in existing programs related to care management, integrated behavioral health, pharmacist, and social services support. The main responsibilities of the role are:

Develop a comprehensive knowledge of Humana's Primary Care 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 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

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

Required Qualifications

Experience in healthcare field

Strong program development skills and attention to detail

Develop and deliver well-prepared training that engages participants, uses active listening skills, demonstrates organization, and continually analyzes and improves all aspects of delivery and content.

Takes initiative and able and willing to work autonomously

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.

Experience developing and/or utilizing data for performance and operational metrics

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 PCO 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 and emotional intelligence

Ability to travel up to 50%

Preferred Qualifications

Registered Nurse

Health solutions system experience in the areas of Population Health Management and/or care management.

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

40

Company info

Humana Inc.
Website : http://www.humana.com