Role: Clinical Quality Frontline Leader Assignment: Clinical Quality Location: Work at home in any location preferably EST or CST time zones
Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humana’s Perfect Service® means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.
Assignment Capsule Be part of a clinical leadership team by leading a team of quality associates in a fast-paced and metric-driven environment driving process improvements using sound quality methodologies.
Humana is seeking a Clinical Quality Frontline Leader. In this role, you will directly lead and mentor 8-15 associates supporting Humana HCS Clinical Operations to ensure accurate delivery of services and operational excellence by applying Humana Capital strategies which focus on continuous improvement in the areas of contributions, competencies and performance.
Scope of Role and Responsibilities: * Manage, prioritize and balance incoming associate audit work and staffing resources using work flow modelling and application to meet business needs and expectations
Ensure timely and accurate metric results are delivered to business
Identify process improvement opportunities using audit data and applying sound quality methodologies
Establish clear performance metrics and accountability for quality associates and partner with operations to establish and maintain associate performance metrics
Coach and develop quality staff by providing frequent feedback on all aspects of performance during one on one meetings and/or through training
Provide guidance and leadership to associates and serve as a mentor for their day-to-day activities
Verify and validate associate timekeeping data submitted each pay period
Monitor, identify and resolve performance/behavior/attendance issues using prescribed performance management techniques
Maintain visible presence and partnerships with operational leaders and staff
Communicate continuously and proactively across the quality team and amongst business units supporting or collaborating
Two years of prior experience leading teams
Strong leadership and coaching skills
Proficient with Microsoft Office Suite of products
Excellent communication and presentation skills
Effectively work in a team environment
Strong problem solving skills
Ability to handle multiple tasks simultaneously Role Desirables
Experience in healthcare, quality field or call center environment
Certified Quality Auditor or experience in quality audit
Certified Six Sigma Green Belt or Lean Sigma
Knowledge of accreditation standards (URAC, NCQA)
Familiarity with CMS guidelines including interpretation and application
You will have 8-15 direct reports, and you will report to a manager. This area is under the leadership of the director of Quality and Facilitation – Business Improvement. Additional Information
At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.
Title: Clinical Quality Frontline Leader
Other Locations: US-Texas-San Antonio, US-IN-Indianapolis, US-WI-Green Bay, US-TN-Brentwood
Requisition ID: 192162
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.