Transplant Case Manager Frontline Leader; | Humana ; | Louisville KY 40202 USA; | Full Time .
Requirements; | Details; | Locations; | Contact .
Job Description: .
Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9 million medical members. 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. Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.
Assignment Summary: Transplant Management is responsible for guiding members in need of solid organ and bone marrow transplant. It is the single area in Humana that ensures the members' understanding of their transplant benefits. By steering members to the Humana National Transplant Network, the Transplant Clinical Advisor maximizes available transplant benefits, while providing the member with a point of contact for transplant related services.The Transplant Frontline Leader is responsible for a team of Transplant Clinical Advisors. He/She will be responsible for coaching their team of Transplant Clinical Advisors, providing direction on difficult cases, monitoring the quality of the interactions with members and providers, and participating in development and implementation of Transplant Management's Quality Management System, policies and procedures and metrics.The Transplant Frontline Leader will work closely with the Transplant Process Manager, and, NTN and Transplant Claims Leadership. The Transplant Frontline Leader will serve as a resource for internal Humana department and external business partners.Competencies:
Strong knowledge of transplant related services and processes
Strong knowledge health care delivery systems and benefit plans
Demonstrate a high level of experience with PC based and online computer applications
Possess excellent verbal and written communication skills
Possess strong analytical abilities
Strong demonstrated interpersonal skills, conflict resolution skills, and investigative stills
Strong leadership skills
Must be able to make appropriate decisions in the face of ambiguity
Ability to work autonomously in work at home environmentEducation:
Bachelors Degree in Nursing or Health Related Field
Ability to be licensed in multiple states
Have at least three years clinical nursing experience, preferable in critical care or oncology nursing
Previous experience in case management, utilization management, discharge planning, and home health care and/or rehabilitation preferred
Previous management, leadership, coaching, training experience requiredAdditional Requirements
Ability to manage time and resources effectively
DSL Access or Cable Modem accessibility
Designated/Secured work area to conduct business (i.e. home office)
Ability to work/train in Louisville for 2-4 weeks, plus additional travel as needed for ongoing training
Ability to work on a phone queue with a work schedule :8:30-5:00 PM EST
Currently holds a valid nursing license with out restrictions
Ability to train in Louisville, Kentucky for up to 2 weeks, plus additional training as needed
Ability to travel on an ongoing basis, as needed, with flexibility to meet business needs; to include but not limited to associate home audit visits, interviewing, coaching through field visits, participation in new hire training, and various leadership meetings, and planning sessions .