Clinical Strategy Lead

Become a part of our caring community and help us put health first
 

Humana is a $100 billion (Fortune 50) 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.

Within Clinical Strategy, the Enterprise and Specialty Strategy team employs a rigorous process to set specific clinical priorities for the enterprise. They identify the greatest sources of value and lead a multi-disciplinary process to identify opportunities for enhanced clinical outcomes, cost control, quality, and member experience. This is a remote opportunity to join a dynamic team within Humana and work on complex and diverse clinical priorities while getting experience and exposure within Clinical Strategy and across the enterprise.

Location: remote nationwide but preference for Louisville, KY

The Clinical Strategy Lead will analyze complex problems and issues related to member care, care quality/outcomes, and medical cost. This role is highly collaborative and will work closely with associates and executive leaders from across the enterprise to solicit input, collaborate externally to identify opportunities in value-based healthcare, guide data and literature/evidence backed problem solving, and make recommendations to advance our clinical strategy. This individual will promote innovative solutions and work with enterprise partners to develop strategic recommendations and support execution efforts with operational leaders. Specifically, this individual will be part of a team that leads non-PCP and specialty risk initiatives, amongst other home-based and virtual care clinical innovations, to reduce total cost of care while improving clinical quality and member experience. This individual will partner with internal and external stakeholders to design, validate scale new innovative value-based care/ alternative payment models in risk-based healthcare.

The Clinical Strategy Lead will:

• Engage in an ambiguous problem solving and strategy setting process on specific clinical priorities for the organization.

• Use data and insights from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members.

• Lead a multidisciplinary team to define the discrete opportunities that are both impactful and achievable.

• Work directly with our business partners across the organization to create the strategic plan and roadmap to execute and capture prioritized opportunities.

Key Skills and Abilities necessary for success:

• Experience leading cross-functional teams to achieve meaningful results.

• Effective communication skills both verbally and in writing.

• Proven skills influencing others and a track record of success working through ambiguity.

• Ability to interpret and leverage data to support recommendations.

• Skill in developing and delivering persuasive presentations to all levels in the organization.

• Independent judgment and decision making on complex issues regarding job duties and related tasks.

Use your skills to make an impact
 

Role Essentials

• Bachelor’s degree

• 7 or more years of experience creating and driving strategy, or 4 or more years of experience with a related graduate degree (e.g. MBA or MHA, etc.)

• 2 or more years of consulting experience

• 2 or more years of project leadership experience

• Experience in the health care industry

• Excellent verbal and written communication skills with the ability to communicate effectively with senior leaders

• Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis

• Competency with Microsoft Office suite (PowerPoint, Excel)

Role Desirables

• Master's degree

• Experience working with providers and/or hospital systems

• Exposure or experience with clinical care delivery and interventions and/or care management

• Experience with value-based care strategy and/or operations

• Prior work within Medicare Advantage

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of these 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.

Scheduled Weekly Hours

40

Pay Range

The 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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$115,200 - $158,400 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, 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.

Application Deadline: 02-27-2025

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.