Humana Bilingual Referral Regional Operations Manager in Miami, Florida

Role : Bilingual Referral Regional Operations Manager

Assignment : Care Delivery

Location : Miami, Florida

We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our patients, providers, employers, agents and others we work with.

At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our patients, employers, providers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.

As a company whose primary focus is on the well-being of its patients, Humana is dedicated to shifting perceptions of the health insurance industry. We believe our role includes being a “well-being partner” who will empower consumers to live a life that’s healthy, active and rewarding. Success in these efforts ensures our ability to deliver on promises to key stakeholders.

Assignment Capsule

Be a part of our Care Delivery Referral Operations Leadership Team– use your proven operations, critical thinking and leadership skills to manage a multi-regional team for various clinical, financial, and overall segment initiatives.

Humana is seeking aBilingual Referral Regional Operations Manager to lead a team and evaluate and analyze various aspects of Humana’s Care Delivery segment:

  • Accountable for managing the operations of referral teams in centralized and non-centralized, multi-city geographic areas

  • Responsible for department financial/budget performance

  • Responsible for assisting in the development and implementation of associate engagement optimization efforts

  • Responsible for assisting with provider network management to include network adequacy

  • Responsible for collaborating, identifying and creating efficiencies in the current referral processes

  • Responsible for building and maintaining excellent working relationships with internal departments, vendors and external provider partnerships

  • Coach and develop associates to improve performance and prepare for future positions

    Key Role Objectives

  • Develop comprehensive knowledge of the Care Delivery Referral strategy, capabilities, best practices, tools, and the current state

  • Lead the day to day referral operations for designated Regions/Markets, including responsibility for patient/customer service/quality, and policies and procedures

  • Support Clinical Operations, Center Operations and Shared Services departments and leaders with operational and financial goals/budgets

  • Work closely with the Market Director to develop performance goals for the Referral Department

  • Work closely with the Market Director assessing which specific strategies and tools will be most effective in developing relationships with the provider community

  • Align with the Humana Medical Directors and Operators within the Market, to foster strategic provider relationships and assist in identifying and hitting identified targets

  • Ensure successful execution of attracting, developing, motivating, and retaining talent

    Key Competencies

  • Interpersonal Effectiveness: Understands oneself, effectively manages emotions, listens and communicates with respect, and builds trusting relationships.

  • Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.

  • Accountability: Meets established expectations and takes responsibility for achieving results; encourages others to do the same.

  • Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first.

    Role Essentials:

  • Health care or managed care with Utilization Management, Operational Management and Provider Relations experience

  • Demonstrated management experience and partnering with senior leadership on strategic initiatives

  • Proven planning, preparation and presenting skills

  • Established knowledge regarding process review and improvement

  • Experience coordinating the activities of diverse functions

  • Demonstrated ability to manage multiple projects and meet deadlines

  • Comprehensive knowledge of all Microsoft Office applications

  • Ability to travel as needed at a rate of approximately 50%

    Role Desirables:

  • Bachelor's degree strongly preferred

  • Reporting and analytics experience

    Reporting Relationships

  • The Referral Regional Operations Manager will report to the Referral Market Director, and have 5 or more direct reports and a full team of up to 70 staff as the Regions continue to expand. Reports may include Manager(s), Front Line Leader(s), and Referral Coordinators.

    Additional Information

    As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information 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 Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Title: Bilingual Referral Regional Operations Manager

Location: FL-Miami

Requisition ID: 177873