CLevelCrossing
Associate VP Behavioral Strategy
CLevelCrossing, Boston, Massachusetts, us, 02298
Description
Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.
Against that backdrop, we are seeking an accomplished healthcare leader for the newly-created role of Associate Vice President, Behavioral Health Strategy. In this role, you will be a key enterprise leader, with responsibility for evolving Humana's behavioral health strategy, with a focus on our 5 million Medicare members. You will also facilitate the delivery of high quality, appropriate, and cost-effective behavioral healthcare for Humana's members, which includes guiding the development and implementation of behavioral health strategies, tactics, policies, and programs to ensure appropriate outcomes and drive reductions in total cost of care.
To succeed in this position, you must appreciate the needs of our members with behavioral health conditions, the challenges of meeting those needs within the current system, and the highest yield opportunities for improvement. You must also be passionate about collaborating and partnering across the enterprise (e.g., with Clinical Operations, Markets, Care Management, Analytics, Pharmacy, etc.) to develop discrete, high-value strategies and to ensure execution of those strategies. And finally, you must be driven by sustainably improving health outcomes for some of our most vulnerable members.
The Associate Vice President will lead a small team and will report directly to our Vice President, Clinical Strategy. This position can be located anywhere within the lower 48 states.
Responsibilities
Key Responsibilities: Develop and execute an enterprise-wide behavioral health strategy that sustainably improves behavioral outcomes for our members across insurance segments, with a focus on the Medicare line of business. Establish key metrics of success for this strategy and measure progress against them. Metrics should be inclusive of quality, access, and financial metrics, such as medical trend reduction and administrative costs. Collaborate with partners across the enterprise to develop, articulate, implement, evaluate, and refine a set of strategic initiatives that address, but are not limited to, the following domains: Access:
Ensure Humana members with behavioral health needs have access to appropriate and high-quality behavioral health care by optimizing network design, benefit design, care management, and referral pathways. Analytics and Measurement:
Evolve enterprise approach to behavioral health outcome measurement to improve our ability to identify trends, highlight areas for improvement, establish tactics for advancing outcomes, and evaluate the impact of our strategic initiatives. Work collaboratively with enterprise teams to evaluate and synthesize data to inform clinically appropriate, cost-effective solutions to advance the behavioral health management of members. Outcomes:
Characterize the impactable drivers of poor outcomes and avoidable spending for members with behavioral health needs and identify and implement cost-effective strategies for impacting these outcomes that draw on existing enterprise capabilities. Internal Operations and Technology:
Support efforts to improve the efficiency of health plan operations (utilization management, claims payment, provider contracting) to reduce friction for members, providers, and associates. External Partnerships:
Explore, evaluate, and implement novel partnerships with national and community-based organizations that will expand Humana's ability to impact behavioral health outcomes. Innovation:
Support behavioral health innovation including increasing access to virtual and specialty care and advancing value-based payment models. Establish and maintain external relationships to ensure awareness of leading-edge innovation and policy changes in behavioral health; represent Humana and Humana's behavioral health strategy in external venues. Key Candidate Qualifications:
The ideal candidate will have extensive healthcare industry experience (typically 10 years) or related experience leading the development and implementation of complex strategic and/or operational initiatives. He/she will understand the behavioral health ecosystem-including gaps and opportunities to improve the value and quality of care-especially for seniors. In addition, this person will demonstrate leadership effectiveness and ability to design and implement constructive change within an organization and across multiple organizations. Bachelor's degree is required, although an advanced degree in a relevant field will be advantageous. In addition to the above, the following qualifications and personal attributes are sought: A record of success leading diverse cross-functional teams to execute on complex projects within a matrixed organization, and moving them toward a common vision related to motivation, engagement, and goal attainment. Demonstrated analytic acumen, with the ability to leverage data to drive decision making and improve outcomes. Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with senior and executive level audiences. Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs concurrently and win their co-ownership in the outcome. Current or recent experience in a large, highly matrixed company (i.e., Fortune 250), with proven ability to influence cross-functional teams, leaders, and key stakeholders in such an environment. Strong leadership skills, with proven success in expanding and elevating the capabilities and performance of the team. Deep understanding and experience with behavioral health strategy and operations in a managed care setting. This is a remote position. #LI-Remote Scheduled Weekly Hours: 40 Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.
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Key Responsibilities: Develop and execute an enterprise-wide behavioral health strategy that sustainably improves behavioral outcomes for our members across insurance segments, with a focus on the Medicare line of business. Establish key metrics of success for this strategy and measure progress against them. Metrics should be inclusive of quality, access, and financial metrics, such as medical trend reduction and administrative costs. Collaborate with partners across the enterprise to develop, articulate, implement, evaluate, and refine a set of strategic initiatives that address, but are not limited to, the following domains: Access:
Ensure Humana members with behavioral health needs have access to appropriate and high-quality behavioral health care by optimizing network design, benefit design, care management, and referral pathways. Analytics and Measurement:
Evolve enterprise approach to behavioral health outcome measurement to improve our ability to identify trends, highlight areas for improvement, establish tactics for advancing outcomes, and evaluate the impact of our strategic initiatives. Work collaboratively with enterprise teams to evaluate and synthesize data to inform clinically appropriate, cost-effective solutions to advance the behavioral health management of members. Outcomes:
Characterize the impactable drivers of poor outcomes and avoidable spending for members with behavioral health needs and identify and implement cost-effective strategies for impacting these outcomes that draw on existing enterprise capabilities. Internal Operations and Technology:
Support efforts to improve the efficiency of health plan operations (utilization management, claims payment, provider contracting) to reduce friction for members, providers, and associates. External Partnerships:
Explore, evaluate, and implement novel partnerships with national and community-based organizations that will expand Humana's ability to impact behavioral health outcomes. Innovation:
Support behavioral health innovation including increasing access to virtual and specialty care and advancing value-based payment models. Establish and maintain external relationships to ensure awareness of leading-edge innovation and policy changes in behavioral health; represent Humana and Humana's behavioral health strategy in external venues. Key Candidate Qualifications:
The ideal candidate will have extensive healthcare industry experience (typically 10 years) or related experience leading the development and implementation of complex strategic and/or operational initiatives. He/she will understand the behavioral health ecosystem-including gaps and opportunities to improve the value and quality of care-especially for seniors. In addition, this person will demonstrate leadership effectiveness and ability to design and implement constructive change within an organization and across multiple organizations. Bachelor's degree is required, although an advanced degree in a relevant field will be advantageous. In addition to the above, the following qualifications and personal attributes are sought: A record of success leading diverse cross-functional teams to execute on complex projects within a matrixed organization, and moving them toward a common vision related to motivation, engagement, and goal attainment. Demonstrated analytic acumen, with the ability to leverage data to drive decision making and improve outcomes. Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with senior and executive level audiences. Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs concurrently and win their co-ownership in the outcome. Current or recent experience in a large, highly matrixed company (i.e., Fortune 250), with proven ability to influence cross-functional teams, leaders, and key stakeholders in such an environment. Strong leadership skills, with proven success in expanding and elevating the capabilities and performance of the team. Deep understanding and experience with behavioral health strategy and operations in a managed care setting. This is a remote position. #LI-Remote Scheduled Weekly Hours: 40 Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.
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