Regional Clinical Advisor

@ Humana

Overview

Become a part of our caring community at Humana and help us put health first. As a Regional Clinical Advisor, you will join the regional clinical team to support data-driven clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program. You will work closely with regional leadership and cross-functional teams to drive improved member health outcomes.

Key Responsibilities

• Analyze chronic condition performance and support provider education.
• Evaluate clinical program effectiveness through data analysis.
• Identify opportunities for clinical program initiatives.
• Prepare data for governance and oversight committees.
• Collaborate with internal stakeholders and cross-functional teams.
• Support compliance with clinical practices and regulatory standards.

Collaboration & Compliance

Work directly with the Regional VP of Health Services and Health Services Director to implement initiatives, manage vendor relationships, and support quality improvement efforts. You will also serve as a clinical liaison to ensure consistency in program execution and address performance issues when necessary.

Qualifications

A Bachelor’s degree in a health-related field is required, along with a minimum of 5 years of clinical experience and at least 3 years in data analytics, clinical operations, care management, quality improvement, or vendor oversight. Proficiency in Excel, Tableau, and Power BI is expected. Strong communication, organizational, and problem-solving skills are essential. Experience in value-based care, population health, and managing vendor relationships is highly valued. The ability to work independently in a remote environment is required, with anticipated travel between 5-15%.

Preferred Qualifications

An advanced degree (MSN, MBA, MHA, MPH) and experience in managed care, health plan operations, or Medicare Advantage programs are preferred. Experience with remote monitoring, digital health tools, or clinical innovation platforms and project management certification (e.g., PMP, Lean Six Sigma) is a plus.

Travel & Schedule

This is a remote position with occasional travel to Humana offices for training or meetings. The scheduled weekly hours are 40.

Compensation & Benefits

The base pay is estimated between $104,000 and $143,000 per year, with eligibility for a bonus incentive plan. Humana offers competitive benefits including medical, dental, vision, retirement savings, paid time off, and more.

Key skills/competency

• Clinical Strategy
• Data Analytics
• Performance Monitoring
• Quality Improvement
• Medicare Advantage
• Vendor Management
• Cross-functional Collaboration
• Compliance
• Healthcare Innovation
• Remote Work