Humana Hiring for VP, Operations Clinical Support at Atlanta Full Time

Become a part of our caring community and help us put health first

With an increased focus on driving efficiencies for increased productivity and sustainable growth, the Clinical Operations organization is seeking an experienced leader to lead the combined organization bringing together all Utilization Management (UM) and Care Management (CM) operational support, back office, and delivery teams, including all non-clinical intake/inbound calls, back office, and support functions. This newly established organization will help drive opportunities for efficiency, effectiveness, and business optimization for Clinical Operations as well as identify opportunities across the broader Medicaid and Medicare business segment.

This position is remote US. However not in Hawaii, Alaska or Puerto Rico

This role will report to the SVP Clinical Operations

Responsibilities

• Leadership of full-scale operations of all non-clinical, intake, and back-office functions for both Utilization Management and Care Management operations

• Lead the overarching non-clinical vendor strategy and oversight for the function including identifying new opportunities

• Responsible to drive innovation and new business strategies to optimize processes, workforce consolidation, centralization efforts spanning Medicare and Medicaid segment

• Driving optimization initiatives through outsourcing/offshoring strategies.

• Deliver year over year business value through optimization initiatives contributing to admin savings and productivity achievement

• Partner with other business areas across Medicaid and Medicare to identify innovation, automation, and consolidation opportunities

• Achieve operational excellence through member and provider service metrics, net promoter results, and other KPIs.

• Act as an executive change leader, driving change and transformation to engage associates to bring multiple organization functions together in support of a cohesive business strategy

• Reporting to this role will include the following functions:

• UM Clinical Intake and back office (Medicare, Commercial, Medicaid, Letters, Fax, Web pends)

• CM Non-Clinical Leaders and teams (Inbound, Outbound, Transition of Care teams, Stars support, etc.)

• Personal Attributes : Works with an enterprise mindset, ability to operate across functions within the segment, highly collaborative, clinical knowledge and expertise, business and financial acumen, collaborator, driver of change.

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or related field

• 10 or more years in service, clinical or contact center operations.

• Experience with contracting, workforce optimization, outsourcing, vendor oversight

• 8 or more years of leadership experience

• Track of delivering results through transformational change

• Demonstrated experience enabling a strong culture of associate experience

• Strong business and financial acumen

Preferred Qualifications

• Master’s degree in related field

Additional Information:

• Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ~~~ with instructions on how to add the information into your official application on Humana’s secure website.

• To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipEmployees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

• Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities

Scheduled Weekly Hours

40

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of ?Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of ?Humana?to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ~~~.