The Lead Clinical Implementation Consultant serves as the clinical subject matter expert responsible for translating utilization management requirements into consistent operational workflows and technology solutions. This role provides clinical leadership for enterprise initiatives by interpreting clinical requirements and ensuring they are accurately implemented across clinical decision support tools, electronic prior authorization, claims operations, and supporting technology platforms. Working collaboratively with Medical Directors, Referrals and Authorizations, Claims, Product, and Technology, this position ensures new clinical services, procedure codes, and utilization management requirements are implemented consistently throughout the organization while improving provider experience, operational efficiency, and clinical accuracy. Our Government Contract Requires US Citizenship for this Position The Clinical Business Lead oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact Required Qualifications 3 Bachelor's degree 3 2 or more years of project leadership experience 3 8 or more years of technical experience 3 Applicable State licensure in field of study 3 Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Additional 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.