Saturday , April 20 2024

Humana Remote Jobs – Sr Market Clinical Engagement Professional

Website Humana

Job Description:

The RN Senior Market Clinical Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to promote and improve clinical performance and quality outcomes within assigned geographic markets and /or assigned provider relationships. Influences and consults on matters related to utilization metrics, care delivery programs and member-level care opportunities, to promote population health approach to patient care. The RN Senior Market Clinical Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Job Responsibilities:

The RN Senior Market Clinical Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to promote and improve clinical performance and quality outcomes within assigned geographic markets and /or assigned provider relationships. Influences and consults on matters related to utilization metrics, care delivery programs and member-level care opportunities, to promote population health approach to patient care. The RN Senior Market Clinical Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

You will engage and collaborate with providers and clinical personnel, to identify opportunities to enhance care delivery and improve the health and wellbeing of Humana members:

  • Identify, leverage and deploy tools, resources and vendor relationships to improve member outcomes
  • Identify both population health and member level opportunities to improve clinical performance and health outcomes
  • Facilitate external discussions and workgroups with medium to large provider practices on improvement opportunities, development and implementation of tactical improvement initiatives, workflow development, and monitoring of outcomes.
  • Participate in internal Provider Engagement strategy and /planning meetings
  • Consult with internal resources to identify opportunities for improving provider/member outcomes related to clinical utilization , disease management program participation, quality care gaps and social determinates of health.

Job Requirements:

  • Strong organizational skills
  • Knowledge of Medicare policies, processes and procedures
  • Knowledge of Medicare policies, processes and procedures
  • Demonstrated ability to manage multiple projects at once and meet deadlines
  • Comfortable facilitating clinical workgroup meetings and leading external clinical discussions
  • Proven experience in completing efficient health related research, with associated analysis and drawn conclusions
  • Licensed Registered Nurse (RN) with no disciplinary action.
  • Experience using Microsoft Teams application
  • Quality Improvement experience including HEDIS and STARs
  • Bachelor’s degree
  • Excellent communication skills, written and verbal
  • Comprehensive knowledge of all Microsoft Office application with proficiency in Excel, PowerPoint and Word
  • Passionate about working in a team environment with shared accountability to improve consumer experience and health outcomes

Job Details:

Company: Humana

Vacancy Type:  Full Time

Job Location: Houston, TX, US

Application Deadline: N/A

Apply Here

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