Case Management, Regional Process Mgr - Milwaukee – Waukesha

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. 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.

Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.




Role: Case Management, Regional Process Manager
Assignment: Commercial Case Management
Location: Milwaukee, WI

Are you a fit?
Are you an innovative leader? Do you enjoy directing a regional team of clinical professionals in the coordination of health care? Do you have a strong attention to detail and like solving problems? If this sounds like you, then read on!

Assignment Capsule

• Design and develop new initiatives within case management program for process improvement and communicating recommendations for change to intervention leader
  
• Manage the day to day regional operations including case management quality initiatives
  
• Drive the business performance indicators and analysis of clinical program results in conjunction with the program leadership team
  
• Assist the department in preparing for and maintaining ISO registration
  
• Provide oversight for departmental communications efforts such as responding to RFP's and providing informational presentations to internal/external customers
  
• Assist in analysis of program metrics and outcomes as part of the operational reporting package
  
• Direct supervision of the Case Management frontline leaders, who serve as supervisors to the RN clinical advisors
  
• Interface with local market medical officers and program leaders to drive the Clinical Guidance Organization's strategic initiatives

Key Competencies

• Builds Human Capital: You deliver current, direct, complete and actionable feedback to associates to support continuous learning and growth; while ensuring that diverse perspectives are widely held, modeled and promoted. By selecting, deploying, developing and rewarding diverse talent, you are able to foster Humana's strategy and meet business requirements.
  
• Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.
  
• Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
  
• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Role Essentials

• Valid RN license without restrictions
  
• Bachelor's degree of higher in Nursing, Business or related field
  
• Minimum of 3 years experience performing direct supervision of case managers
  
• Minimum of 5 years experience in a clinical setting
  
• Excellent organizational and time management skills
  
• Ability to work with minimal supervision and self-managed time

Reporting Relationships
Reports to Director of Commercial Case Management based in Louisville, Kentucky (Corporate Headquarters)

Additional Information
Knowledge of case management software applications, URAC standards and accreditation processes helpful. Will require travel 30 %. Daily use of Microsoft Office, internet and intranet applications and virtual meeting software.

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