Job Details

Clinical Health Services - Delegation Compliance Consultant West Coast

Company name
Humana Inc.

Location
Louisville, KY

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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

Assignment: Licensure

and Business Partner Compliance

Location: West

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. 

 

Assignment

Capsule

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.

 

Humana

is seeking a Compliance Consultant to develop and maintain key relationships by

working with internal and external business partners to evaluate and maintain

compliance.

Efficiently

track, report, and communicate all audit information to delegates and

required internal departments.

Review

and analyze the delegates’ policies and procedures as well as files to

ensure they are compliant with regulatory and legislative requirements

Issue

corrective action plans as applicable.  Work with the assigned

delegates until the issue has been resolved.

Develop

and maintain key relationships with the assigned delegates to optimize

business results.

Assist

in special projects that promote department efficiency.

Primarily oversight of West Coast Providers

','!*!Role

Essentials

RN/LPN/LVN licensureProficient

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

Excellent

communication skills, both oral and written

Ability

to work independently under general instructions and with a team

Ability

to travel 25%

Role

Desirables               

Knowledge/understanding

of regulatory and legislative requirements

Auditing

or consulting experience

Project

coordination or management experience

Metrics

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)

Company info

Humana Inc.
Website : http://www.humana.com

Company Profile
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.

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