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Job title

Consultant - Atlas Clinical Program Rules

Company Humana
Wage between $0.00 - $0.00 Annually
Location United States, Kentucky, Louisville
Employment type Full Time
Education Bachelor
Year Experience 1 - 2 Years of Practical Experience
Travel None
Published on 9/29/2009
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: Atlas Business Rules Consultant, Clinical Programs
Assignment: Atlas Rules Guidance for Clinical Programs
Location: Louisville, KY

Are you a fit?
Do you have a passion for being able to impact and influence the direction of people's thinking through the impactful delivery of research findings? Do you enjoy creating models and metrics to drive member engagement? If so, this role may be for you!


Assignment Capsule
As the Atlas Business Rules Consultant you will be accountable for developing and maintaining key relationships and work with assigned area to optimize business results.
  • Serve as an expert in strategic/operational support and direction for Clinical Program rules portfolio.
  • Perform opportunity generation and rules drafting that drive member engagement through internal and external clinical programs.
  • Monitor execution of rules portfolio including configuration, deployment and routing; Coordinate effectively with stakeholders.
  • Perform impact analysis in collaboration with stakeholders and manage constituent expectations.
  • Integrate with the Clinical Programs leadership, strategy leadership, and front line operations.
  • Represent the Health Guidance Organization to internal and external audiences as required..



Key Competencies
  • Builds Trust: You honor your word by doing what you say you are going to do.
  • Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.
  • Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
  • 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.


Role Essentials
  • Domain knowledge of programs and medical management and outcomes process; clinical experience desired
  • Bachelors degree in a related field required or equivalent experience
  • 3+years hospital or health plan managed care experience
  • Knowledge of appropriate levels of care and health care delivery systems
  • Ability to successfully multitask and lead major projects and program implementation with flexibility.
  • Process-integration experience
  • Skillful influencer and relationship minded
  • Excellent communication skills, written/verbal
  • Excellent PC skills (including MS Office suite) required
  • Strong organizational skills


Role Desirables
  • RN with Active License, BSN or Bachelors in a related field

    Reporting Relationships
    You will report to the Atlas Rules Leader. This area is under the leadership of the SVP for Network, Clinical and Pharmacy Operations.df-tc

    Experience/Skills
    See Above
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