Senior Accreditation Utilization Management Professional

Welcome to Humana, where our mission is to help our members achieve their best health. We are seeking a highly skilled and experienced Senior Accreditation Utilization Management Professional to join our team. In this role, you will play a crucial role in ensuring the quality and effectiveness of our utilization management program. As a company that values diversity and inclusivity, we welcome candidates from all backgrounds to apply. If you are a driven and dedicated professional with a passion for promoting optimal health outcomes, we encourage you to read on and apply today.

1. Develop and implement policies and procedures for utilization management in accordance with industry standards and best practices.
2. Monitor and evaluate the effectiveness of the utilization management program, identifying areas for improvement and implementing necessary changes.
3. Collaborate with cross-functional teams to develop strategies and initiatives that support the overall mission of promoting optimal health outcomes for our members.
4. Conduct regular audits and reviews to ensure compliance with accreditation standards and government regulations.
5. Lead and mentor a team of utilization management professionals, providing guidance and training as needed.
6. Utilize data and analytics to identify trends and patterns and make data-driven decisions to improve the utilization management program.
7. Stay updated on industry trends and changes in accreditation standards to ensure the utilization management program remains current and effective.
8. Serve as a subject matter expert and liaison with external accrediting bodies, advocating for the organization's best interests.
9. Communicate and collaborate effectively with internal stakeholders, including senior leadership, to ensure alignment and support for the utilization management program.
10. Foster a culture of diversity and inclusivity within the team and organization, promoting an environment where all members feel valued and supported.

According to JobzMall, the average salary range for a Senior Accreditation Utilization Management Professional in Louisville, KY, USA is $72,000 to $104,000 annually. This range can vary depending on factors such as years of experience, education level, and specific job responsibilities.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.