Humana

Director, State Public Policy

San Antonio, Texas, United States

Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, Pharmaceutical Benefits ManagementIndustries

Requirements

Candidates must possess a Bachelor's degree and have 8 or more years of experience in state legislative or executive branches, regulatory boards, trade groups, intergovernmental groups, consulting firms, or private sector public policy functions. A minimum of 8 years of experience in pharmacy and/or PBM public policy is required, with a direct understanding of pharmacy/PBM operations and the relevant state public policy environment. Strong knowledge of state health administrative/regulatory/licensure rules and guidance, as well as state health policy, is essential. Demonstrated relationships with policymakers and thought leaders in the state public policy arena are also required, along with a track record of applied analysis, research, and resource development supporting healthcare policy and translating information into actionable policy.

Responsibilities

The Director, State Public Policy will represent the organization's position on legislation and regulatory affairs to elected officials, regulatory agencies, and their staff. This role involves leading the development of state public policy positions for pharmacy and PBM businesses, analyzing state policy trends, and drafting deliverables to support business strategy. Responsibilities include contributing policy expertise to state-level advocacy efforts, informing leadership on legislative and regulatory trends, identifying business risks and opportunities in external state policy developments, and providing regulatory guidance. The Director will also prepare testimony, regulatory comments, and position statements, develop and maintain a repository of legislative and regulatory analyses, and represent Humana before various advocacy groups and state boards. Maintaining awareness of competitor and industry positions, and performing necessary research and analyses to support enterprise positions are also key duties.

Skills

State Public Policy
Pharmacy Licensure
PBM
Healthcare Policy
Legislative Analysis
Regulatory Affairs
Advocacy
Business Strategy
Risk Analysis

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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