Job Snapshot
Location:
Sandy, UT 84070
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Industry:
Other Great Industries
Manages Others:
Not Specified
Job Type:
Executive
Health Care
Education:
Graduate Degree
Experience:
At least 3 year(s)
Contact Information
Contact:
http://www.humana.com/careers
Description
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.
Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.
Role: Clinical Innovations Medical Director
Assignment: Senior Products
Location: Sandy, UT
Are you a fit?
Do you enjoy defining clinical strategy for a major market area? Do you have a desire to be in a position where you can 'provide guidance to our members related to their health care needs? Does this sound like you? If so, then read on!
Assignment Capsule
As a Clinical Innovations Medical Director you will provide medical leadership and strategy for a regional Health Services Operations with fiscal responsibility for trend management.
- Play an active role in the regional medical community.
- Ensure participation on market committees that require medical expertise.
- Provide support and ensures compliance with all regulatory issues related to utilization management.
- Implement quality improvement programs as defined by corporate leadership and CMS.
- Responsible for medical interpretation, reviews, and decisions as required for plan administration.
Key Competencies
- Leveraging Technology: You are technological 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.
Role Essentials
- Current MD license in the state(s) in which you are required to practice
- Ability to be licensed in multiple states without restrictions
Advanced experience working in a private medical practice or in a hospital setting.
Role Desirables
- Health Plan experience
- Previous Medicare/Medicaid Experience a plus
- Previous experience leading teams focusing on utilization management, discharge planning and/or home health or rehab
- Bilingual is a plus
Reporting Relationships
You will report to a Regional CEO. This area is under the leadership of the SVP & Chief Operating Officer.
Additional Information
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