Humana Expands Clinical Advisor Role

As part of ongoing efforts to improve quality and communication, Humana has expanded the role of the clinical advisor position within its market-level quality departments. Clinical advisors, who are registered nurses, have traditionally worked on various quality initiatives, including gathering information for the Health Plan Employer Data and Information Set (HEDIS®), conducting clinical studies and interventions and performing National Committee for Quality Assurance (NCQA®) activities. In their new expanded role, clinical advisors will now also work more closely with the provider relations staff to help support physicians and their clinical staff.

Clinical advisor registered nurses will visit physicians’ practices regularly to assess needs and provide various types of support. Activities may include providing patient educational materials, helping to identify patients for disease management programs and conducting medical record reviews.

“We are very excited about the expansion of the clinical advisor role,” said Karen Feldkamp, Humana’s corporate director of quality. “The clinical advisor nurses find direct interaction with physician offices professionally rewarding and hope to assist physicians with meeting the educational needs of their Humana-insured members.”

The clinical advisor position is intended to complement the provider relations representatives’ role, by addressing practices’ clinical questions and needs. Humana expanded the role of this position in January and will continue to introduce the new responsibilities in all markets throughout 2006.

To reach your local clinical advisor, contact your local market quality office.

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