Oncology Program Lead

Job not on LinkedIn

🔥 26 minutes ago

🏄 California, Illinois, +2 more states – Remote

🏄 California – Remote 🌽 Illinois – Remote 🦬 Montana – Remote 🗿 South Dakota – Remote

💵 $115.2k - $158.4k / year

⏰ Full Time

🟠 Senior

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• design, implement, and optimize clinical programs that drive quality, safety, and efficiency across healthcare delivery systems • drive improvements in patient outcomes, quality, cost efficiency, and service delivery • serve as the primary liaison between the organization and the Oncology UM vendor • establish contractual KPIs, SLAs, and quality metrics to ensure delivery of safe, effective, and efficient care • conduct regular business reviews and performance discussions with vendor leadership • ensure adherence to evidence-based oncology guidelines, UM policies, and regulatory standards • partner with internal clinical, operations, and compliance teams to optimize workflows and program outcomes

🎯 Requirements

• Registered Nurse (RN) • 7+ years of experience in vendor management, program management, or clinical operations • 3-5 years or more of oncology experience in case management, utilization management or quality review or auditing • Experience applying clinical guidelines and medical policies • Experience reviewing oncology treatment plans • Proven ability to manage complex programs and drive performance outcomes • Advanced analytical, problem-solving, and decision-making skills • Proficiency in Microsoft Office tools (Excel, Word, Outlook); ability to work with data systems and reporting tools

🏖️ Benefits

• 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