Provider Programs Strategic Product Lead

San Antonio, Texas, United States

Apply with AI Apply

Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a Bachelor's degree, knowledge and experience in managed care, and 8 or more years of technical experience. Additionally, 2 or more years of project leadership experience is required, along with proven expertise in problem resolution, strong data and analytics skills, and experience navigating large, complex organizations. Proficiency in Microsoft Excel and PowerPoint, the ability to articulate ideas effectively, strong relationship-building skills, and a passion for improving consumer experiences are also necessary. A Master's degree in Business Administration or a related field, management consulting experience, and Six Sigma certification are preferred.

Responsibilities

The Provider Programs Strategic Product Lead will identify, develop, and implement programs to influence providers, members, and market leadership towards value-based relationships and improved quality metrics. This role involves developing programs to drive value-based relationships, partnering with leaders on implementation planning, and reviewing and communicating program results. The lead will advise executives on functional strategies, exercise independent judgment on complex issues, and transform provider prospective programs to maintain industry leadership, leverage interoperability assets, and meet regulatory challenges. The role also includes serving as an owner for strategic areas of focus and advising on managing program spend while growing revenue.

Skills

Program Development

Strategic Planning

Value-Based Care

Medicare Advantage

Provider Engagement

Interoperability

Regulatory Compliance

Financial Management

Roadmap Development

Stakeholder Management

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.

Land your dream remote job 3x faster with AI

Try Jobo Free