[Remote] Care Management Strategy Lead at Humana

Kentucky, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor’s degree with 6 or more years of relevant strategic work experience creating and driving cross-functional strategy OR Master’s degree with 4 plus years of the same experience
Experience interpreting and leveraging data and analytics to improve strategy and make recommendations, with strong problem-solving skills
Experience completing analysis and modeling of data to drive qualitative and quantitative insights and recommendations for strategy advancement
Experience leading cross-functional group of leaders/teams and initiatives
Experience communicating effectively, both verbally and in writing, and adapting messaging for various audiences, including senior leadership
Proven skills influencing others and a track record of success leading through ambiguity
Proven organization, planning and prioritization skills to collaborate with multiple enterprise departments and stakeholders and the ability to execute

Responsibilities

Drive initiatives to analyze complex problems and issues related to care management using data and insight from internal and external sources with a focus on Stars performance and members served in care management programs
Provide data-backed strategic direction to identify and address business issues and opportunities related to the high-needs Medicare Advantage and SNP (Special Needs Plan) populations that benefit from Humana’s Care Management services
Identify and operationalize opportunities to improve member health outcomes, member and care manager experience, clinical quality, Stars program performance and savings to medical costs
Work with operational owners and key business partners to translate strategic recommendations into execution plans for end-to-end implementation
Solve diverse and complex problems by bringing your own contributions while partnering with other key stakeholders from across the enterprise (clinical, quality, operations, analytics, enterprise Stars team and business)
Engage in an ambiguous problem solving and strategy setting
Use data and insight from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members in care management programs
Communicate initiatives to audiences at all levels of the organization
Lead cross-functional teams with an ability to influence without authority
Give definition to discrete opportunities that are both impactful and achievable
Forecast the value of key initiatives
Work directly with cross-functional partners across the enterprise to create the execution model and roadmap for prioritized opportunities
Use your skills to make an impact

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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