CMS Programs Quality Strategy Lead

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The CMS Programs Quality Strategy Lead will support Humana through successful participation in CMS/CMMI (Centers for Medicare and Medicaid Innovation) Multi-Payor and Accountable Care Initiatives.

Immediately leveraging a successful Medicare Advantage framework and robust provider relationships, this role supports Humana in assuming financial risk for Original Medicare beneficiaries through participation in CMS' Medicare Shared Savings Program (MSSP).

The CMS Programs Quality Strategy Lead develops and implements the Humana MSSP strategy.

Responsibilities

• Assists in developing and directing overall Humana MSSP quality strategy.
• By using a combination of big-picture vision, deep value-based care experience and a “seeking to understand and improve” approach, defines MSSP success, creates a vision for success, and defines the strategy to drive success.
• Partners externally with contracted ACO providers to focus on quality performance.
• Partners cross-functionally with business areas across the broader Humana enterprise such as clinical, legal, and compliance.
• Fosters external and internal partnerships using their communication skills.
• Reports directly to the Director of Value-Based Strategies - CMS Programs.

Required Qualifications

• 6+ years of Medicare or Medicaid experience
• 3+ years of Quality and/or HEDIS experience
• 3+ years project management experience with mid to large scale projects
• Experience with CMMI (Centers for Medicare and Medicaid Innovation) programs
• Experience working with senior leadership
• Solid experience building templates, standard documentation, and disseminating best-in-class knowledge
• Experience facilitating cross-departmental projects
• Excellent oral and written communication skills
• Flexible, dynamic personality who works well in a team environment

Preferred Qualifications

• Bachelor's Degree
• Master's degree in Business and/or related field
• 3+ years experience with data extraction and analysis technologies

Benefits

In addition to being a great place to work, Humana also offers industry-leading benefits for all employees, starting your FIRST day of employment. Benefits include:

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
• And more

Use your skills to make an impact.

Work at Home/Remote Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
• Wireless, Wired Cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership.

Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Our Hiring Process

As part of our hiring process, we will be using an exciting interviewin