Humana

Stars Program Delivery Lead

San Antonio, Texas, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Program Delivery Lead - Preventive Care

Position Overview

Become a part of our caring community and help us put health first. The Stars Member Engagement team and Preventive Care Pod is seeking a passionate, strategic, and collaborative teammate to accelerate preventive care efforts for Medicare Advantage members. The Program Delivery Lead will improve Stars quality metrics and member health outcomes by strategically identifying, developing, and implementing programs that make it easier for members to complete preventive visits with their PCP as well as complete appropriate cancer screenings. This associate will work on problems of diverse scope and substantial complexity, use independent judgement on analysis of variable factors, and own their work and project milestones. Due to the cross-functional nature of the work, this individual will work closely with multiple internal and external business partners to help ensure that progress is being made toward goals. A broad range of skills including strategic thinking, data interpretation, and program management will be required.

Responsibilities

The Program Delivery Lead will:

  • Work closely with the Preventive Care cross-functional Pod and the Stars Member Engagement team, HEDIS Operations team, and other internal business partners to design and implement initiatives that support long-term strategy.
  • Work with vendors on programs as needed; Monitors program operations and results.
  • Reviews and communicates results of internal and external programs.
  • Prioritize strategic focus areas and make recommendations for cross-functional work teams through data-driven decision making.
  • Competent to work independently at the most advanced level across multiple areas.
  • Effectively communicate strategy and influence partners to impact Stars through story telling.
  • Oversee current day-to-day operational functions, while mapping futuristic needs and enhancements.
  • Identify and communicate opportunities and risks to business partners and leadership to anticipate downstream impacts.

Key Competencies

  • Operational strategy development, prioritization and execution
  • Influence and strategic decision making
  • Program management
  • Adaptability in fast moving/changing environment
  • Analytical thinking and data interpretation
  • Use your skills to make an impact

Role Essentials

  • 8+ years of strategy development and implementation.
  • Proficiency in evaluating complex data, using that data to tell a story, and presenting it clearly.
  • Ability to interpret and leverage data and analytics to improve strategy and make recommendations.
  • Experience in strategy consulting, business strategy, clinical and/or operations areas.
  • Strong presentation skills.
  • Demonstrated ability to articulate ideas effectively in both written and oral forms.
  • Effective facilitator and influencer.

Role Desirables

  • Master's Degree in Public Health, Business Administration or a related field.
  • Knowledge and experience in health care environment/managed care and/or Medicare Stars.
  • Agile or product management certification a plus.
  • Strong analytics background.

Employment Type

  • Full time

Location Type

  • [Information not provided]

Salary

  • [Information not provided]

Additional Information

  • Internet Service Requirements: For Home or Hybrid Home/Office employees, internet service must meet at least a download speed of 25 Mbps and an upload speed of 10 Mbps. Wireless, wired cable, or DSL connection is suggested. Satellite, cellular, and microwave connections may be used only if approved by leadership.
  • Internet Expense Reimbursement: Employees living and working from Home in California, Illinois, Montana, or South Dakota will receive a bi-weekly payment for their internet expense.
  • Telephone Equipment: Humana will provide appropriate telephone equipment for Home or Hybrid Home/Office employees.
  • Work Environment: Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
  • Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Application Instructions

  • [Information not provided]

Company Information

  • [Information not provided]

Skills

Strategic Thinking
Data Interpretation
Program Management
Cross-functional Collaboration
Vendor Management
Communication
Storytelling

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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