Clinical Innovations Specialist (Senior Segment) – Metairie

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: Clinical Innovations Specialist
Location: Metairie, La

Assignment Capsule
As a Clinical Innovations specialist you will:

• Assisting Humana nurses with data entry
  
• Take incoming calls from providers inquiring about authorizations and researching Humana systems for any information that is needed to resolve claim/authorization issues
  
• Make outbound phone calls to members
  
• Document all calls and the arrangements you have decided upon
  
• Assist the Clinical team with various clerical and administrative tasks as necessary
  
• Participate in special projects as assigned by the Clinical Director

Key Competencies

• Builds Trust: You honor your word by doing what you say you are going to do.
  
• Champions the Customer: You keep closely attuned to the needs and perspectives of customers and use this insight for the benefit of the business.
  
• 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.
  
• Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.

Role Essentials

• College Degree preferred
  
• Medical office or insurance company background
  
• Working knowledge of clinical applications or a demonstrated technical aptitude and an ability to quickly learn new systems
  
• Proficiency in all Microsoft Office applications, including Word, Excel and Access
  
• Familiarity with medical terminology and/or ICD-9 codes preferred
  

Reporting Relationships
You will report to a Clinical Operations Manager.

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