Senior Strategy Advancement Professional (Provider Experience)
DescriptionThe Senior Strategy Advancement Professional will be a part of a team bringing a passion for serving and enhancing our member and provider experience in the integrated plan model. A successful individual can provide data-based strategic direction to identify and address business issues and opportunities. They will provide business intelligence and strategic planning support for business segments or Humana at large. They will lead initiatives to analyze complex business problems and issues using data from internal and external sources. The Senior Strategy Advancement Professional brings expertise or identifies subject matter experts in support of multi-functional efforts to identify, interpret and produce recommendations and plans based on company and external data analysis. They will ensure that policies and procedures align with corporate vision. The Senior Strategy Advancement Professional will exercise independent judgment and decision making on complex issues regarding job duties, related tasks, and works under minimal supervision.
- Leads alignment of people, process, and technology to create new ways of working within Humana to elevate our member, provider, and associate experience in the areas which most significantly elevate provider experience including, but not limited to: network, directory, provider support model, cross-over provider experience, single front door for Prior Authorizations(PAs), claims and credentialing.
- Drives progressive administrative alignment between Medicare and Medicaid operations which elevates the member’s experience to achieve enterprise strategic objectives.
- Demonstrates independent judgment and decision making on complex issues regarding job duties and related tasks.
- Possesses the ability to self-start and work under minimal supervision.
- Demonstrates ability to collaborate cross-functionally to develop innovative solutions supporting the enterprise initiatives.
- Creative and innovative thinker, willing to think beyond the status quo, ask probing and curious questions to drive results.
- Ability to be a change agent by embracing shifts in ways of working to meet the need of the business and enterprise goals.
- Bachelor's degree or 5 years’ experience working in health plan operations.
- 3 or more years of experience working in the Medicare/Medicaid space.
- 3 or more years of project leadership experience specific to activities which drive the member and provider experience.
- Project management experience.
- Medicare/Medicaid integrated model experience.
- Experience/knowledge working in a cross-functional setting.
- Deep familiarity of Humana teams, systems and processes which collectively deliver the member and provider experience.
- Workstyle: This is a remote position.
- Travel: Up to 10% possibly outside of your state of residence.
- Workdays & Hours: Monday – Friday; Eastern Standard Time (EST)with some flexibility.
- For Candidates who live in Indiana: According to the Indiana Office of Inspector General Rule, 42 IAC 1-5-14 Post-Employment Restrictions, if you are a current or former state officer, employee or special state appointee with Indiana Family and Social Services Administration (FSSA) within the past year, engaged in the negotiation or the administration of a Medicaid contract on behalf of the state and/or Family and Social Services Administration (FSSA); in a position to make discretionary decision affecting the: (1) outcome of the negotiation; or (2) nature of the administration; or either engaged in making a regulatory or licensing decision that directly applied to Humana Inc. or to a parent or subsidiary you cannot be considered for this opportunity. For more information please visit: IG: Indiana Office of Inspector General
Work at Home Criteria
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Scheduled Weekly Hours40
Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$84,600 - $116,300 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.