Program Delivery Lead/Stars Market Member Experience and Outreach - CAPHS

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Candidates must possess a Bachelor's degree in business administration, health administration, public health, marketing, or a related field, coupled with over 7 years of experience in program delivery, customer experience strategy, service design, and/or business improvement. Experience in provider engagement or provider experience at a market level is required, along with strong analytical skills in qualitative and quantitative data. Proven ability to collaborate productively across organizations for cross-functional initiatives, support program delivery from definition to execution and measurement, and excellent planning and organizational skills to meet deadlines are essential. Familiarity with behavioral/experience design frameworks in healthcare programs and working knowledge of healthcare or clinical concepts is also necessary. A Master's degree and experience with the CMS Star Rating Program and CAHPS survey measures are preferred.

Responsibilities

The Program Delivery Lead will oversee the successful execution of Humana's Stars CAHPS initiatives, acting as the primary point of contact for program strategy and delivery. This involves developing and implementing programs to positively influence member perception and health outcomes, leveraging insights and analytics for member-facing interventions, and focusing on market and provider engagement. Responsibilities include defining program strategy, creating market-specific interventions, facilitating communication among stakeholders, establishing the learning agenda, managing delivery plans, monitoring program outcomes, and communicating status updates. The role also involves synthesizing insights into actionable takeaways, guiding program execution for performance improvement, reviewing and communicating initiative results, and managing business partner relationships.

Skills

Program Delivery

Member Experience

Outreach

Analytics

Intervention Development

Market Engagement

Provider Engagement

Stakeholder Communication

Strategic Planning

Performance Monitoring

CAHPS SME

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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