Remote Clinical Operations Lead (Medicare/Medicaid)

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

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