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Humana

Sells Medicare health plans and runs senior clinics

Director, Care Management

Medical, Clinical & VeterinaryPosted on Nov 11
Full-timeRemote in USA

About the Job

Requirements

  • At least 8 years of technical experience.
  • At least 5 years of management experience, including at least 2 years leading leaders.
  • Bachelor’s degree in business, finance, or a clinical field.
  • Prior work experience in the health solutions industry with demonstrated success directing and leading teams.
  • Expertise in developing and executing specific measurable goals focused on outcomes.
  • Understanding of and experience driving proactive performance management across a team of scale.
  • Proficiency in analyzing and interpreting financial trends.
  • Experience developing and implementing complex resource plans.
  • Comprehensive knowledge of Microsoft Office applications, including Word, Excel, and Access.

Responsibilities

  • Oversee the assessment and evaluation of members’ needs and requirements to help achieve and/or maintain an optimal wellness state.
  • Guide members and families to appropriate resources that support care, wellbeing, and overall health outcomes.
  • Facilitate coordination and interaction with internal and external resources to meet member care needs.
  • Lead the implementation of new and updated programs, as well as large-scale functional projects.
  • Support and enhance technical and operational procedures and processes within care management.
  • Implement strategic plans and provide input into functional strategy.
  • Drive departmental goals and objectives to improve overall performance and outcomes.
  • Direct and lead teams within the health solutions industry.
  • Analyze and interpret trends to support decision-making, program effectiveness, and operational improvements.
  • Utilize Microsoft Office applications, including Word, Excel, and Access, to support reporting, analysis, and communication.
  • Contribute to an organization focused on continuously improving consumer experiences.

Desired Qualifications

  • Master’s degree in Business Administration or a related field.
  • RN state license in field of study.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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