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Health Services Lead at Humana - ApplyBlast

Health Services Lead

Humana

3 months ago

3.6 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

The Health Services Lead serves as the subject matter expert and operational leader for Utilization Management clinical programs, ensuring clinical integrity, regulatory alignment, and consistency across markets. This role partners with market teams, strategy advisors, and cross‑functional partners to translate clinical requirements into policies, standardized workflows, and scalable processes that support national UM strategy.

Responsibilities

Validate clinical workflows and provide recommendations
Guide utilization management program design and implementation
Review and develop policies and procedures
Assess implementation readiness and identify workflow gaps
Evaluate post‑implementation program effectiveness

Skills

Qualifications

Registered Nurse (RN)Licensed Practical Nurse (LPN)Licensed Clinical Social Worker (LCSW)Licensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)

About Humana

humana.com

Headquarters

Louisville, Kentucky, United States

Company Size

10001+ employees

Founded

1961

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