Clinical Nursing Manager
4 weeks ago
The Clinical Nursing Manager is responsible for leading the utilization management team in ensuring high-quality, cost-effective, and appropriate allocation of member services, treatments, and resources.
This role requires a strong clinical background, excellent communication skills, and the ability to work independently and as part of a team.
The ideal candidate will have experience in utilization management, leadership, and clinical nursing, with a strong understanding of healthcare operations and regulatory requirements.
Key Responsibilities:
- Lead the utilization management team in achieving operational goals and metrics
- Develop and implement policies and procedures to support business needs and maintain compliance with regulatory requirements
- Analyze operational and analytical reports to monitor and track operational efficiency
- Collaborate with the multi-disciplinary care team to maximize quality of patient care while achieving effective medical cost management
- Provide oversight, education, support, and coaching to ensure associates' performance meets expectations and regional operational goals
Requirements:
- Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA, NE, KS, MO, or a compact license, with no disciplinary action
- 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
About Humana:
Humana is a leading health and well-being company that puts health first for our teammates, customers, and communities. We make it easier for people to achieve their best health through our insurance services and CenterWell healthcare services.
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