Senior Clinical Delegation Vendor Oversight

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

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