Clinical Health Services - Delegation Compliance Consultant (West Coast)','183489','US-KY-Louisville','US-New Mexico, US-KY-Louisville, US-Arizona, US-California','Office, Virtual/Work At Home','Office, Virtual/Work At Home','Full-time','Yes, 25 % of the Time','!*!Role: Clinical
Health Services – Delegation Compliance Consultant
and Business Partner Compliance
Coast based and/or ability to travel 25% to provider locations as needed
Healthcare isn’t just about health anymore. It’s about caring for family,
friends, finances, and personal life goals. It’s about living life fully. At
Humana, we want to help people everywhere, including our associates, lead their
best lives. We support our associates to be happier, healthier, and more
productive in their professional and personal lives. We encourage our people to
build relationships that inspire, support, and challenge them. We promote
lifelong well-being by giving our associates fresh perspective, new insights,
and exciting opportunities to grow their careers. At Humana, we’re seeking
innovative people who want to make positive changes in their lives, the lives
of our members, and the healthcare industry as a whole.
Be a part of Compliance – Use your business knowledge to help analyze and
develop policies, procedures and programs supporting our compliance
initiatives? As a Delegation Compliance Consultant, you will perform oversight
audits of our clinical health services delegates to ensure compliance with
current state/federal regulations as well as Humana standards.
is seeking a Compliance Consultant to develop and maintain key relationships by
working with internal and external business partners to evaluate and maintain
track, report, and communicate all audit information to delegates and
required internal departments.
and analyze the delegates’ policies and procedures as well as files to
ensure they are compliant with regulatory and legislative requirements
corrective action plans as applicable. Work with the assigned
delegates until the issue has been resolved.
and maintain key relationships with the assigned delegates to optimize
in special projects that promote department efficiency.
Primarily oversight of West Coast Providers
knowledge of MS Word, Excel and PowerPoint
Knowledge/understanding of utilization management,
complex case management, disease management and/or delegation
laws, regulations and accreditation requirements
communication skills, both oral and written
to work independently under general instructions and with a team
to travel 25%
of regulatory and legislative requirements
or consulting experience
coordination or management experience
and report development experience
','Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.','Clinical Health Services - Delegation Compliance Consultant (West Coast)
Website : http://www.humana.com
Humana's diverse lines of business work to serve all types of consumers. From families to seniors to military members to self-employed individuals, there is a plan to meet many unique needs. Find out how Humana's associates and corporate leaders are committed to customer service. Our team uses innovation to deliver results to our consumers.