Health Planning & Support Front Line Leader position at Humana in Green Bay

Humana is currently seeking to employ Health Planning & Support Front Line Leader on Fri, 04 Oct 2013 02:23:33 GMT. As a Clinical Guidance Frontline Leader you will hire, lead and develop clinical and non- clinical professional associates. Collaborate with other health care givers in reviewing actual and proposed medical care and services against established Guidelines. Report trends Develop system-view recommendations Implement appropriate actions to control trend Create and conducts provider outreach...

Health Planning & Support Front Line Leader

Location: Green Bay Wisconsin

Description: Humana is currently seeking to employ Health Planning & Support Front Line Leader right now, this position will be placed in Wisconsin. For complete informations about this position opportunity kindly see the descriptions. As a Clinical Guidance Frontline Leader you will hire, lead and develop clinical and non- clinical professional associates. Collaborate with other healt! h care givers in reviewing actual and proposed medical care and services against established Guidelines.

Report trends

Develop system-view recommendations

Implement appropriate actions to control trend

Create and conducts provider outreach initiatives

Ensure compliance with regulatory requirements

Recommend services for Humana Plan members utilizing care alternatives available within the community and nationally

Recommend alternatives if appropriate using your knowledge of clinical protocols

Identify members for specific case management and / or disease management activities

Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions

Key Competencies

Leveraging Technology:
You are technologically savvy and know how to appropriately share and use your knowledge to improve business results.

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.

Is Accountable:
You meet clearly stated expectations and take responsibility for achieving results.

Clinical Knowledge:
You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs.

Communication:
You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

Qualifications

Role Essentials

Current RN license in the state in which the nurse is / will be required to practice Ability to be licensed in multiple states without restrictions

Progressive clinical experience preferably in an acute care, skilled or ! rehabilitation clinical setting

Prior supervisory experience

Ability to work independently under general instructions and with a team

Valid drivers license and/or dependable transportation necessary

Role Desirables

BSN or Bachelors degree in a related field

Health Plan experience

Prior Medicare / Medicaid experience

Call center or triage experience

May substitute equivalent education and/or experience for degree

Previous experience in utilization management, discharge planning and/or home health or rehab

Bilingual is a plus

Additional Information

Schedule

:

Full-time

Primary Location

:

US-WI-Green Bay

Other Locations

:

US

Role

:

Clinical Innovations and Health Practitioners

Work Environment Type

:

Virtual/Work At Home

Travel
:

Yes, 10 % of the Time
- .
If you were e! ligible to this position, please email us your resume, with salary requirements and a resume to Humana.

If you interested on this position just click on the Apply button, you will be redirected to the official website

This position starts available on: Fri, 04 Oct 2013 02:23:33 GMT

Apply Health Planning & Support Front Line Leader Here