Clinical Nursing Manager

3 days ago


Pierre, South Dakota, United States Humana Full time
Job Summary

We are seeking a highly skilled Clinical Nursing Manager to join our team at Humana. As a key member of our healthcare services team, you will be responsible for ensuring high-quality, cost-effective, and appropriate allocation of member services, treatments, and resources.

Key Responsibilities
  • Develop and implement policies and procedures to support business needs and maintain compliance with regulatory requirements.
  • Provide oversight, education, support, and coaching to ensure associates' performance meets expectations and regional operational goals/metrics.
  • Manage attendance, schedules, assignments, and compliance expectations to ensure adequate coverage during traditional and non-traditional business hours.
  • Analyze operational and analytical reports to monitor and track operational efficiency.
  • Function as a clinical resource for the multi-disciplinary care team to maximize the quality of patient care while achieving effective medical cost management.
Requirements
  • Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA, NE, KS, MO, or a compact license, with no disciplinary action.
  • Utilization Management experience is required for this role.
  • 2+ years management or leadership experience in a clinical setting.
  • Strong attention to detail, excellent time management and organizational skills.
  • Excellent communication skills both verbal and written.
  • Proficient with Microsoft Word, Outlook, and Excel.
  • Ability to work independently under general instructions and with a team.
Preferred Qualifications
  • Bachelor's degree in nursing (BSN).
  • MCG Milliman experience.
  • Health Plan experience.
  • Previous Medicare experience a plus.
Work Environment

This role will have 12-14 direct reports. Scheduled weekly hours are 40. Pay range is $84,600 - $116,300 per year. This job is eligible for a bonus incentive plan.

Humana offers competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, company and personal holidays, volunteer time off, paid parental and caregiver leave, short-term and long-term disability, life insurance, and many other opportunities.



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