Job added in hotlist
Applied job
Contract job
90-day-old-job
part-time-job
Recruiter job
Employer job
Expanded search
Apply online not available
View more jobs in Lancaster, SC
View more jobs in South Carolina

Job Details

Senior Clinical Delegation Vendor Oversight

Company name
Humana Inc.

Location
Lancaster, SC, United States

Employment Type
Full-Time

Industry
Healthcare, Nursing

Posted on
Aug 03, 2021

Apply for this job






Profile

Description

The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

Location: work at home anywhere

The Senior Clinical Delegation Vendor Oversight builds relationships with and provides clinical and operational oversight for third party vendor relationships maintained by the Employer Group Product team. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Understands the Commercial Product, segment, and organizational strategy and objectives, including their linkages to related areas.

Senior Clinical Delegation Vendor Oversight will:

monitor the clinical performance of the third party vendor from implementation through lifecycle

make recommendations to improve or adjust vendor partnership to meet the intended objectives

manage day-to-day integration and provide guidance on operational integration

conduct vendor business reviews in accordance with compliance requirements

advise Commercial Product of milestone progress, identified risks or barriers, and outcomes

provide direction to cross functional teams, maintaining clear lines of communication

communicate regularly with Commercial Product regarding business impacts

participate in third party vendor evaluations, contributing recommendations based on clinical analytics

Key objectives for the Senior Clinical Delegation Vendor Oversight:

Develop and maintain collaborative relationships between Clinical and Commercial Product

Collaborate with business partners and recommend opportunities to optimize vendor quality

Facilitate the measurement of success metrics

Maintain Clinical org awareness and education contemporary knowledge of industry changes and innovations

Once travel restrictions are lifted travel will be around 20/25%

Role Essentials

Associates Degree in Nursing

Registered Nurse

5 or more years of vendor management, operations, project management and/or service level oversight including quality, compliance and performance experience

Experience in managed care or health care administration

Demonstrated experience leading through influence, setting vision and goals and leading change.

Demonstrated experienceinfluencing strategy, metrics, measurements, and trends.

Excellent PC skills (including MS Word, Excel and PowerPoint)

Excellent communication skills, written and verbal with demonstrated ability to communicate with Leaders across the organization

Strategic thinking and planning capabilities; organized and detail-oriented

Ability to manage multiple projects across business segments

Role Desirables

Bachelors in Nursing or a related field

Previous experience managing program performance and service levels

Commercial experience

Proven leadership skills

Prior Market Operations experience

Additional Information

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com

Similar Jobs:
Medical Director - Work at Home
Location : Lancaster, SC
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-d...
Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Lancaster South Carolina Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination,...
Senior Pre-Authorization Nurse
Location : Lancaster, SC
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Ma...
I like the volume of jobs on EmploymentCrossing. The quality of jobs is also good. Plus, they get refreshed very often. Great work!
Roberto D - Seattle, WA
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
HealthcareCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
HealthcareCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 HealthcareCrossing - All rights reserved. 168 192