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The Director, Provider Strategy Advancement provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Director, Provider Strategy Advancement requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Director of Provider Strategy Advancement will report to the Medicare East Division Finance Leader and will be responsible for leading and improving the end-to-end provider service disengagement process and developing and designing ways to build capacity and drive change. The role will require close collaboration with cross-functional teams across the Enterprise and will support all Regions. It will also require a strong partnership with our National Provider and Corporate Operational teams. Additional responsibilities include:
- Manages the overall provider terms program and is responsible for improving key metrics of member experience, retention, and Stars
- Maintains oversight of the process for coordinating and tracking impacts of potential/likely provider terminations across all regions
- Works autonomously across teams to optimize every aspect of the operational processes related to processing a provider termination and identify and mitigate member and provider friction points
- Oversees governance and progress against opportunity areas
- Influences key partners in an effort to simplify and improve business processes, using the consumer experience as a key tenet
- Identifies additional opportunity areas and prioritizing resources against them
- Understands provider changes (new or disengaging) in advance to create processes to handle member and provider questions and calls
- Develops key insights around the downstream impacts of provider terminations around Stars, member experience and retention, and provider contracting decisions
- Leverages data analytics to drive business insights, reporting, and leadership communications around provider disengagement
- Advises Medicare leadership of functional strategies while exercising independent judgment and decision making on complex issues with minimal supervision
- This will be an individual contributor role
Use your skills to make an impact
Required Qualifications
- Bachelor’s degree
- 5+ years of experience with operations, finance, product, or organizational development
- 2+ years Medicare experience
- Experience working with provider contracting, corporate provider operations, or market operations functions
- Experience defining and leading transformational change at an enterprise level with senior leadership
- Experience leveraging data analytics to identify improvement opportunities and influence change
- Experience developing methods and criteria for measuring and summarizing data for complex analyses
- Experience in leading a complex, high-profile and high-risk program/operation to success
- Ability to influence and collaborate at senior levels within and outside the organization
- Executive level presentation and communication skills, both written and oral
Preferred Qualifications
- Master’s degree in Business Administration, Finance, or related field
- Deep knowledge of Humana organization structure, leaders, and systems
Additional Information
Work-At-Home Requirements
- To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
- Wireless, Wired Cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
- Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates 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 associates 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
Our Hiring Process
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
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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.
$168,000 - $231,000 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.
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.
