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Innovation Portfolio Strategy Advisor

Role overview

Qualifications

  • Bachelor’s degree in healthcare, business, or related field
  • 7+ years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting
  • Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives
  • Proven ability to work with multiple stakeholders, lead cross-functional teams and implement strategic initiatives

Responsibilities

  • Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access across both MA and MCD
  • Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality
  • Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency
  • Launch and lead Pay-for-Performance (P4P) projects for MA providers

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • English

Hard skills

Other skills

  • Analytical Skills
  • Communication
  • Leadership
  • Problem Solving

About the company

Humana logo

Humana

Health Insurance (Payers)

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Become a part of our caring community
 

The Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. You will accomplish the product strategy developed by the portfolio director by translating strategy into actual product delivery. The Portfolio Strategy Advisor works across departments to form colleague teams that can support overall delivery of a product, sets prioritization, maintains alignment of effort, and owns delivery.

The Innovation Portfolio Strategy Advisor is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) LOBs. This position will focus on developing and executing strategies to enhance provider performance, ensure true network access, and drive value-based initiatives that improve care quality and member outcomes.

Key Responsibilities

  • Network Access Monitoring:

  • Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access—including Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia—across both MA and MCD.

  • Provider Performance Measurement:

  • Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality.

  • Cross-functional Collaboration:

  • Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency.

  • Value-Based Initiatives:

  • Launch and lead Pay-for-Performance (P4P) projects for MA providers. Support and expand ongoing P4P programs within MCD, driving provider engagement and improved member outcomes.

  • Provider Relationship Management:

  • Manage Joint Operating Committees (JOCs) and sustain ongoing relationships with large provider groups. You will be the contact for issue resolution, troubleshooting, and strategic partnership development.


Use your skills to make an impact
 

Role Essentials

  • Bachelor’s degree in healthcare, business, or related field

  • 7+ years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting

  • Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives

  • Proven ability to work with multiple stakeholders, lead cross-functional teams and implement strategic initiatives

  • Strong analytical skills, with experience in provider performance measurement and network adequacy

  • Demonstrated ability to articulate ideas effectively in both written and oral forms

Role Desirables

  • Master’s degree

  • Experience with value-based care and pay-for-performance models

  • In-depth knowledge of behavioral health provider networks for both MA and MCD populations

  • Ability to manage complex provider relationships and drive collaborative outcomes

Additional Information

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 required; 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.

Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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 yearThis 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 09-06-2026


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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