Job Description
**Become a part of our caring community**
The Nurse Clinical Lead reports to, and partners closely with, the National Medical Director, Risk Adjustment and Stars. They support corporate and regional strategies for provider success in Medicare Stars, Risk-Adjustment (MRA), and Interoperability. This individual provides clinical and coding expertise and serves a vital individual contributor role. They provide clinical guidance for programs, policies, and educational materials to optimize provider performance in these domains.
**Key responsibilities for the Nurse Clinical Lead include the following:**
+ Inform clinical strategy and increase adoption of Humana's Stars, MRA, and Interoperability programs
+ Serve as a clinical coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates
+ Serve as a clinical consultant and subject-matter expert in MRA and St...
The Nurse Clinical Lead reports to, and partners closely with, the National Medical Director, Risk Adjustment and Stars. They support corporate and regional strategies for provider success in Medicare Stars, Risk-Adjustment (MRA), and Interoperability. This individual provides clinical and coding expertise and serves a vital individual contributor role. They provide clinical guidance for programs, policies, and educational materials to optimize provider performance in these domains.
**Key responsibilities for the Nurse Clinical Lead include the following:**
+ Inform clinical strategy and increase adoption of Humana's Stars, MRA, and Interoperability programs
+ Serve as a clinical coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates
+ Serve as a clinical consultant and subject-matter expert in MRA and St...