Clinical Business Lead

Humana Inc; Hartford (CT); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Occasional travel up to 25%

Job summary

Humana Inc. is seeking a Clinical Business Lead to provide comprehensive operational and team lead support for programs serving members who are dually eligible for Medicare and Medicaid.

You will coordinate daily workflows, staffing, and performance, while partnering with clinical and operational leaders to meet priorities and drive accountability. The role includes monitoring productivity and quality, coaching staff, and acting as a liaison with state partners as needed to align with statewide

Qualifications

• Bachelor's degree is required.
• Knowledge of Medicare/Medicaid or dual-eligible programs is required.
• At least 3 years of project leadership experience is required.
• Ability to lead daily operations, coordinate staffing and workloads, monitor productivity and quality, identify performance trends and barriers, provide coaching support, reinforce accountability, and escalate operational concerns as needed.

Responsibilities

• Oversee day-to-day operations and workflow management.
• Coordinate staffing and workloads across programs for dual-eligible members.
• Monitor associate productivity and quality, identify trends and barriers, and coach staff.
• Escalate operational concerns and ensure adherence to priorities with leadership collaboration.
• Serve as liaison with state partners as needed for MI HIDE and State/Regional workflows.

Skills

Project leadership

Healthcare program knowledge

Staff coordination

Education

Bachelor's degree

Job description

Become a part of our caring community

The Clinical Business Lead provides comprehensive, operational and team lead support for programs serving members who are dually eligible for Medicare and Medicaid. This role partners with clinical and operational leaders to coordinate daily workflows and staffing, monitor productivity and quality, identify and address barriers, reinforce accountability, and support consistent execution of operational priorities.

The Clinical Business Lead provides comprehensive team lead support for daily operations, including day-to-day workflow management, staffing coordination, daily dialer and manual list oversight, associate performance monitoring, productivity review, quality awareness, coaching support, and follow-through on operational priorities. You will also support consistent execution of team expectations by identifying performance trends, addressing barriers, reinforcing accountability, and partnering with leaders to ensure associates have the guidance, tools, and support needed to meet operational goals.

In this role, you will provide operational oversight and team lead support for MI HIDE workflows, ensuring work is monitored consistently, barriers are identified promptly, and issues requiring clarification, escalation, or leadership intervention are addressed appropriately. Serves as a liaison with state partners as needed.

Additionally, you will lead support for State/Regional workflows, ensuring alignment with operational priorities, timely follow-up on work activity, consistent communication of expectations, and escalation of workflow, staffing, quality, or performance concerns as needed. You will serve as a liaison with state partners as needed.

Use your skills to make an impact

Required Qualifications

• Bachelor's degree
• Working knowledge of Medicare, Medicaid, and/or programs serving dual-eligible populations
• 3 or more years of project leadership experience
• Demonstrated ability to lead daily operations, coordinate staffing and workloads, monitor associate productivity and quality, identify performance trends and barriers, provide coaching support, reinforce accountability, and elevate operational concerns appropriately

Preferred Qualifications

• 8 or more years technical experience

Additional Information

• Occasional travel up to 25%

Work At Home / Internet Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 10-08-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.