Behavioral Health Leader

Employment Type: Full time

Position Overview

Humana is a $100 billion (Fortune 40) market leader in integrated healthcare, dedicated to helping people achieve lifelong well-being. We are committed to advancing the employment experience and vitality of our associate community. Through offerings anchored in a whole-person view of human well-being, Humana focuses on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.

Humana is committed to putting health first—for its teammates, its customers, and its company. Through its insurance services and CenterWell healthcare services, Humana makes it easier for millions of people to achieve their best health, delivering the care and service they need, when they need it.

Business Strategy & Context

Humana’s strategy centers on providing a consumer-focused, integrated care experience that makes it easy for people to achieve their best health through outstanding clinical capabilities and a simple, personalized experience. A key component is our Integrated Care Delivery model, which places customers at the center of everything we do, focusing on helping them manage their health holistically.

We recognize that health and lifestyle are intrinsically connected. By addressing social determinants of health and removing friction points for customers, healthcare providers, and caregivers, we aim to help people change unhealthy behaviors. Humana is a leader in adopting value-based payment models that reimburse for health outcomes, improving health, boosting quality, and controlling costs. We are also integrating systems and processes using the latest technology to create a simpler, better customer experience, ultimately enabling the best possible health and experience at an affordable cost.

Overall health is a function of both physical and mental health. As a national leader in integrated care, Humana is committed to creating market-leading provider and member experiences that enable improved health outcomes.

Key Facts:

• Over 35% of HUM’s Medicare and Medicaid members have a Behavioral Health (BH) diagnosis, including mild to moderate BH, substance use, serious mental illness, Alzheimer’s/dementia, and other BH needs (ADHD, eating disorders, etc.).
• Within Medicare, these members have claims costs over 2x that of members without BH needs.
• Within Medicaid, these members have claims costs over 7x that of members without BH needs.

Responsibilities

The Behavioral Health Leader will spearhead a transformative effort to define our future-state operating model for Behavioral Health. The primary goals are to:

• Improve health outcomes.
• Reduce medical costs.
• Enhance operational efficiency.
• Reduce provider/member abrasion.
• Improve compliance across Medicare and Medicaid.

Ultimately, this role is responsible for the development and deployment of a new, end-to-end Behavioral Health model at Humana, balancing access, affordability, and health outcomes.

This position plays a pivotal role in enhancing the overall quality of healthcare services, improving our efficiency and effectiveness in delivering behavioral health care, fostering strong relationships with our internal and external stakeholders, and meeting state and federal expectations.

The BH Leader will work with a dedicated executive governance committee with balanced representation across Medicare and Medicaid. The team will consist of 3-5 BH experts reporting into the BH leader. They will also have an aligned Direct Responsible Individual (DRI) from each member of the governance team.

Application Instructions

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Company Information

Humana

• A $100 billion (Fortune 40) market leader in integrated healthcare.
• Clearly defined purpose: to help people achieve lifelong well-being.
• Committed to advancing the employment experience and vitality of its associate community.
• Focuses on stimulating positive individual and population changes through a whole-person view of well-being.
• Nurtures a sense of security, enabling people to live life fully and be their most productive.
• Integrates insurance services and CenterWell healthcare services.
• Aims to make it easier for millions of people to achieve their best health.
• Delivers care and service when and where it's needed.
• Serves Medicare, Medicaid, families, military service personnel, and communities.
• Employs a consumer-focused, integrated care experience strategy.
• Utilizes an Integrated Care Delivery model.
• Addresses social determinants of health and removes friction points.
• Adopts value-based payment models.
• Integrates systems and processes using the latest technology.