[Remote] Strategy Advancement Advisor - LTSS at Humana

Indiana, United States

Apply Now

Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree or equivalent experience in Medicaid managed care
Excellent verbal and written communications
Strategic planning experience at the market level or higher
Proven record of success in driving operational improvement
Experience dealing with external Medicaid and Medicare regulatory agencies
Passionate about contributing to an organization focused on continuously improving consumer experiences
Prior experience with interpreting and acting upon Medicaid and/or Medicare contracts and legal requests
Experience working with HCBS (Home and Community Based Services)
Formal or informal experience with leading teams and/or cross-functional collaboration
Availability to meet in person with state leaders
Must reside in the state of Indiana
Internet speed of at least 25 Mbps download and 10 Mbps upload

Responsibilities

Provides data-based strategic direction to identify and address business issues and opportunities
Provides business intelligence and strategic planning support for business segments or the company at large
Leads initiatives to analyze complex business problems and issues using data from internal and external sources
Advises executives to develop functional strategies (often segment specific) on matters of significance
Liaises between state regulator, plan leadership, and the enterprise to ensure the execution of contract deliverables and operational changes when requested by regulator or deemed necessary
Presents to state regulator on behalf of Humana
Performs audit material reviews, as well as post audit follow-ups as required by the state regulator
Reviews and approves all materials prior to submission to the state regulator. Including; policies and procedures, work plans, and provider and member facing materials
Drives bi-monthly in-person audits with the state regulator
Works with market leadership to maintain important stakeholder relationships throughout Indiana
Oversees the execution of timely regulator deliverables
Maintains intimate familiarity with contractual requirements and stipulations
Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision

Skills

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