Be a part of the CDO Partners in Primary Care leadership team, 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 Partners in Primary Care, 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 Partners in Primary Care, 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.

Responsibilities

Humana’s Care Delivery Organization is seeking a Care Management Program and Strategy leader to be on the national leadership team. This role is key in assisting in the development and stabilization strategy of all Care Management program activities in all existing, new and expansion markets. This role will identify areas of operational development and performance improvement in existing programs related to, nurse care management, integrated behavioral health, pharmacist, and social services support. The main responsibilities of the role are:

• Develop a comprehensive knowledge of Humana’s Care Delivery Organization strategy, best practices and tools
• Identify process improvement opportunities and assist in development and implementation of the solutions
• Identified 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
• Develop, implement and manage team workflows / program training materials
• Will train all new market ancillary resources and ensure that local market trainers are proficient to train on all required elements
• Responsible for proactively obtaining feedback and adjusting training material 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
• Assist in the development of staffing models and ratios for all care team activities
• Participate and coordinate with technology team to ensure technology supports clinical workflows
• Assist in development and coordination with analytics team to develop productivity dashboards and metrics
• Develop, implement and manage quality checks and auditing of workflow and clinical documentation for process improvement purposes
• 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
• Design and implement policy and procedures required to ensure operational stabilization and compliance with all federal, state, and local requirements
• Utilizes data analytics to target development and implementation of clinical program goals and processes to ensure overall success

Required Qualifications

• Clinical related degree or healthcare related field
• Strong program and project management skills
• Proven record and experience the ability to facilitate groups to achieve performance objectives
• 5+ years health solutions system experience in the areas of Population Health Management and/or care management program development and management
• Broad understanding of integrated team based models and programs in a primary care setting
• Strong Medicare industry and value based risk models
• Ability to travel up to 50%
• 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 CDO 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
• Strong consultation and influencing skills
• Ability to multi-task and work in a fast paced environment with changing priorities
• Comprehensive knowledge of Microsoft Office applications, including Word, Excel and Access

Preferred Qualifications

• RN, Family Practice or Geriatric Nurse Practitioner
• Extensive (ideally 5+ years) operational development experience in healthcare markets or a similar integrated care business entity – specifically center based operations experience
• 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

Additional Information

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will read to a set of interview questions and you will enter/text responses to each question. You should anticipate this interview to take about 10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Scheduled Weekly Hours

40