AVP, STARS Enterprise Enablement

Kentucky, United States

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Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health Solutions, Managed Care, HealthcareIndustries

Requirements

Candidates must possess a Master's degree and at least 8 years of management experience, with progressive experience in the health solutions industry, specifically in leading and managing teams. Prior Medicare/Medicaid and managed care experience is required, along with proficiency in analyzing healthcare data, strong attention to detail, excellent communication skills, and comprehensive knowledge of Microsoft Office applications. A Master's degree in Business Administration or Health Administration is preferred, as is knowledge of HEDIS/Stars and CMS quality measures, PMP certification, or Six Sigma Certification.

Responsibilities

The Associate VP, STARS Enterprise Enablement is responsible for developing, implementing, and managing oversight of the company's Medicare/Medicaid Stars Program, directing all Stars quality improvement programs and initiatives. This role requires an in-depth understanding of how organization capabilities interrelate across segments and enterprise-wide. The Associate VP will develop programs to increase plan quality, partner with leaders on implementation planning, and review and communicate program results. Key responsibilities include making decisions on intradepartmental coordination, strategic plan development and implementation, and business outcomes, while developing and implementing strategic plans aligned with the Segment or Business strategy.

Skills

Medicare/Medicaid

Managed Care

Data Analysis

HEDIS/Stars

CMS Quality Measures

PMP

Six Sigma

Microsoft Office Suite

Communication Skills

Organizational Skills

Prioritization Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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