Assignment: Humana Government Business - Clinical Guidance
Location: Work at Home- Nationwide (Central and Eastern time zones preferred)
Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their families. For more than 20 years, Humana Military has strived to create better health outcomes and simplified experiences for millions of beneficiaries across the United States through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches to care drive Humana Military to be a thought leader in the industry and an essential partner to the Government.
The New Beginnings Clinical Advisor will have personal interaction with TRICARE beneficiaries identified for New Beginnings program through analytics or referral. The New Beginnings advisor will provide prenatal education and resources on pregnancy, pregnancy-associated conditions, and chronic health conditions affecting pregnancy. The NB Advisor will provide ongoing support for beneficiaries from the earliest stages of pregnancy up to six weeks following birth or longer for infants in NICU. The NB Advisor will serve as a point of contact for pregnant beneficiaries assisting in planning, coordinating, implementing, monitoring, and evaluating medical services needed to meet the healthcare needs of the TRICARE beneficiaries enrolled in the program. The New Beginnings Clinical Advisor will coordinate with hospitals, attending physicians, the beneficiarys PCM, and other members of the healthcare team to provide ongoing clinical review to include authorizations, concurrent review, and discharge planning services should a mother or infant required extended care. The NB Clinical Advisor will also coordinate care with case managers within HGBs Integrated Care Team, MTF case managers, and facility case managers. UM support for inpatient NICU and new mothers. Perform all duties within the scope of his/her practice.
Our Department of Defense Contract requires U.S. citizenship for this position.
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