Humana
Capture Lead, Medicaid Clinical & Population Health Strategy
Humana, Providence, Rhode Island, us, 02912
Humana Capture Lead, Medicaid Clinical & Population Health Strategy Providence, Rhode Island Apply NowBecome a part of our caring community and help us put health first
Humana Healthy Horizons is seeking a Capture Lead, Clinical & Population Health Strategy, to lead initiatives developing and executing strategy to successfully position Humana for capture growth opportunities. This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, assess, and translate state requirements into actionable go-to-market clinical strategy.
The Lead will consult with growth partners to design and optimize clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations served in target growth markets.
The
Medicaid Capture Management
team's purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function, this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets.
The Capture Lead, Medicaid Clinical & Population Health Strategy key responsibilities include:
Research and assess prospective new markets. Gather key information on market and regulatory landscape and translate state policy to discern impacts to Humana's operating model.
Coordinate operational teams to translate contract requirements, CMS regulations, market intelligence, and industry best practices into a viable target operating model.
Lead cross-functional teams of growth partners and health plan leaders to design high-impact, innovative, and competitive clinical programs, models, partnerships, and initiatives for upcoming growth opportunities.
Develop project plans and roadmaps, driving timely completion of clinical deliverables by cross-functional project team.
Track project status and report on progress to leadership.
Participate in the proposal development process. Provide content and recommendations to help shape responses to state procurements and clearly articulate Humana clinical product strategy.
Document and clearly communicate clinical operating model features to relevant teams to support proposal development and transition to implementation.
Required Qualifications
Must work hours within the Eastern Standard Time Zone.
Bachelor's degree with a strong record of academic achievement.
5+ years of experience in a Medicaid Managed Care Organization (MCO) focusing on Medicaid clinical strategy and population health management strategy. Alternatively, 5+ years of experience in strategy consulting supporting Medicaid managed care clinical strategy and population health management strategy.
5+ years of experience leading cross-functional teams to design and implement Medicaid clinical or population health management strategies or products.
5+ years of experience supporting Medicaid managed care health services operations and the Medicaid managed care business development lifecycle.
Strong problem-solving ability (i.e. adept at quantitative and qualitative research and generating creative solutions).
Ability to operate in a fast-paced environment under tight deadlines and in ambiguous situations.
Highly organized and analytical with a strong attention to detail.
Advanced Proficiency in Microsoft Office Products (i.e. Word, Excel, PowerPoint, Visio).
Excellent verbal and written communication and presentation skills.
Preferred Qualifications
Master's degree in public health or health administration programs.
MBA programs with a specialization in Healthcare Management.
Project Management and Process Improvement qualifications.
Experience and understanding of the delivery system for dual eligibles, including D-SNPs.
Additional Information
Travel:
Role will include travel (10-25% of time)
Workstyle:
Hybrid Office
if you live within commuting distance of our office locations in Tampa, FL or Louisville, KY;
Remote
if you live outside of Tampa, FL and Louisville, KY
Core Workdays & Hours:
8-5pm Monday - Friday; Eastern Standard Time (EST) with flexible scheduling (i.e. occasional nights and weekends)
Benefits:
Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status.
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Humana Healthy Horizons is seeking a Capture Lead, Clinical & Population Health Strategy, to lead initiatives developing and executing strategy to successfully position Humana for capture growth opportunities. This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, assess, and translate state requirements into actionable go-to-market clinical strategy.
The Lead will consult with growth partners to design and optimize clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations served in target growth markets.
The
Medicaid Capture Management
team's purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function, this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets.
The Capture Lead, Medicaid Clinical & Population Health Strategy key responsibilities include:
Research and assess prospective new markets. Gather key information on market and regulatory landscape and translate state policy to discern impacts to Humana's operating model.
Coordinate operational teams to translate contract requirements, CMS regulations, market intelligence, and industry best practices into a viable target operating model.
Lead cross-functional teams of growth partners and health plan leaders to design high-impact, innovative, and competitive clinical programs, models, partnerships, and initiatives for upcoming growth opportunities.
Develop project plans and roadmaps, driving timely completion of clinical deliverables by cross-functional project team.
Track project status and report on progress to leadership.
Participate in the proposal development process. Provide content and recommendations to help shape responses to state procurements and clearly articulate Humana clinical product strategy.
Document and clearly communicate clinical operating model features to relevant teams to support proposal development and transition to implementation.
Required Qualifications
Must work hours within the Eastern Standard Time Zone.
Bachelor's degree with a strong record of academic achievement.
5+ years of experience in a Medicaid Managed Care Organization (MCO) focusing on Medicaid clinical strategy and population health management strategy. Alternatively, 5+ years of experience in strategy consulting supporting Medicaid managed care clinical strategy and population health management strategy.
5+ years of experience leading cross-functional teams to design and implement Medicaid clinical or population health management strategies or products.
5+ years of experience supporting Medicaid managed care health services operations and the Medicaid managed care business development lifecycle.
Strong problem-solving ability (i.e. adept at quantitative and qualitative research and generating creative solutions).
Ability to operate in a fast-paced environment under tight deadlines and in ambiguous situations.
Highly organized and analytical with a strong attention to detail.
Advanced Proficiency in Microsoft Office Products (i.e. Word, Excel, PowerPoint, Visio).
Excellent verbal and written communication and presentation skills.
Preferred Qualifications
Master's degree in public health or health administration programs.
MBA programs with a specialization in Healthcare Management.
Project Management and Process Improvement qualifications.
Experience and understanding of the delivery system for dual eligibles, including D-SNPs.
Additional Information
Travel:
Role will include travel (10-25% of time)
Workstyle:
Hybrid Office
if you live within commuting distance of our office locations in Tampa, FL or Louisville, KY;
Remote
if you live outside of Tampa, FL and Louisville, KY
Core Workdays & Hours:
8-5pm Monday - Friday; Eastern Standard Time (EST) with flexible scheduling (i.e. occasional nights and weekends)
Benefits:
Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status.
#J-18808-Ljbffr