Medical Director of Clinical Informatics

Profile

Description

Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen to identify clinical opportunities to improve health outcomes and improve the value of care for our members. In this exciting start-up environment, you'll have the opportunity to develop clinical trend evaluation processes from the ground up, while working collaboratively with clinicians, actuaries and business owners across Humana.

Responsibilities

Assignment Capsule:

Humana's ECM organization is seeking a Medical Director of Clinical Informatics. This leader will employ a rigorous evidence based appraoch informed through informatics best practices and delivered through a highly collaborative style to support enterprise trend transformation effort. This role will have two main areas of responsibility. Firstly, as a clinical informatics leader you will support enterprise trend governance providing critical clinical and strategy assessment for trend initiatives develop throughout the enterprise. Through working with various partners in trend transformation, retail business, enterprise clinical strategy, clinical products and various analytical organizations you will lead the clinical review and development of clinical leading indicators around various trend initiatives. As well, working collaboratively with the rapid learning team you will design prospective studies designed around relevant clinical leading indicators. Secondly, this role will lead the development of exploratory stage clinically focused trend opportunities employing all the same practices as above.

Responsibilities include:


Responsible for performing clinical review of clinical trend initiatives that could positively impact trend including member experience, health outcomes and costs:
Understand the member/patient & provider experience and how this initiative enables improvements in trend and outcomes
Understand enterprise clinical strategy to be able to assess how trend initiatives align
Guide program owners and trend resources around relevant expected clinical impacts from interventions within the trend initiative
Provide guidance on clinical impacts and potential program design to help enable program success
Perform external literature reviews using evidence based medicine approaches and tools to understand and provide estimates of potential trend impact
Work collaboratively with various analytics resources to develop opportunity sizing and estimates of impact from trend initiatives
Serve as the internal clinical resource for the trend transformation team
Serve as the clinical authority in support of trend governance decisions makers
Collaborate with internal and external clinical subject matter experts as needed to support efforts

Develop clinical leading indicators to support the measurement and testing of clinical trend initiatives
Perform literature reviews using evidence based medicine practices and tools to asses and develop clinical leading indicators
Develop theoretical framework establishing the relationship between clinical trend interventions, clinical leading indicators, and utilization or other relevant return on investment outcomes
Collaboratively with program owners help ensure program design is best developed to improve likelihood of achieving desired clinical impacts
Collaboratively with Rapid Learning Team members, design prospective studies using the clinical leading indicators and expect impact sizes to evaluate interventions and to test the relationships between clinical leading and lagging indictors


Lead Explore stage clinical trend opportunity identification & development


Provide overall leadership to drive initiatives towards desired goals
Using evidence based medicine best practices and clinical expertise synthesize existing & theorized clinical interventions for potential clinical interventions
Use clinical informatics principles and best practices in collaboration with data science and analytics colleagues develop analytical models and analysis related to relevant clinical opportunities
Collaboratively develop clinical and financial models to understand potential impact of interventions
Collaboratively work with various business partners to formalize potential clinical opportunities and seek approval for development of pilot interventions


Required Qualifications


Clinical degree (MD or DO)
3 clinical practice experience
2 years of experience with clinical informatics
Robust experience applying evidence based medicine tools and practice (systematic reviews, risk of bias assessment, etc.)
2 years experience with clinical analytics
Experience collaboratively working with diverse teams, leading through influence, to execute on complex projects
Demonstrated ability to lead through ambiguity and function independently
Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data


Preferred Qualifications


Board certification in clinical informatics
Experience with prospective clinical trial design
Completion of a clinical informatics fellowship
Experience with development of digital health solutions
Master's degree in a quantitative (health services research, public health, epidemiology, biomedical informatics or biostatistics)
Experience with payor claims data analysis
Operational experience at healthcare provider


Travel

Less than 10 % but may change

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40

Company info

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