Clinical Innovations Frontline Leader CL23XX

Job Description: Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.


Participates in the development of, implements, and oversees work for Health Services programs aimed at improving the health and well-being of Humana Medicaid enrollees, which includes, but is not necessarily limited to:


Market level development, implementation and oversight of Disease Management (DM) Programs and staff..


Telephonic management and coordination of care of patients enrolled in Humana internal Disease Management Programs by utilization of nursing skills to triage, assess, monitor, evaluate, instruct, intervene and document goals and outcomes.


Coordination of DM efforts with other Humana departments including, but not limited to Health Services Onsite Staff, Case Management, Quality Improvement and Provider Relations.


Monitor external vendor performance for compliance with program goals.


Collaborate with Health Services Manager for data collection, reporting and Quality Improvement initiatives on all Medicaid clinical programs, including evaluating ongoing effectiveness and improvement opportunities

Searchable Keywords: Clinical Innovations|Frontline Leader|CL23XX / gj-mo

Minimum Education Required: Associate

Years of Experience Required: 3-5 Years

Expected Travel Time: About 50%