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

Humana is a $100 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 of the people served, 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.
Humana is committed to putting health first—for its teammates, its customers, and its company. Through its insurance services and CenterWell healthcare services, Humana makes it easier for the millions of people served to achieve their best health, delivering the care and service they need, when they need it. The result is a better quality of life—not only for people with Medicare and Medicaid but also for families, military service personnel, and communities at large. 
Business Strategy
Humana’s strategy is centered on providing a consumer-focused, integrated care experience that makes it easy for people to achieve their best health through outstanding clinical capabilities and through an experience that is simple and personalized. A key component of this strategy is Humana’s Integrated Care Delivery model, which places customers at the center of everything it does, with a focus on helping them manage their health holistically.
Humana recognizes that health and lifestyle are intrinsically connected. By addressing social determinants of health and by removing difficult friction points for customers and their healthcare providers and caregivers, it can help people change unhealthy behaviors. Humana is a leader in adopting value-based payment models that reimburse for health outcomes, as opposed to services performed, which can improve health, boost quality, and control costs.
Finally, Humana is integrating systems and processes using the latest technology to create a simpler, better customer experience. The ultimate goal of this approach is to enable the best possible health and experience at an affordable cost.
Context:
Overall health is a function of both physical health and mental health. As a national leader in integrated care, Humana is committed to creating market leading provider and member experiences enabling improved health outcomes.
The facts:
• Over 35% of HUM’s Medicare and Medicaid members have a BH diagnosis, including mild to moderate BH, substance use, serious mental illness, Alzheimer’s/dementia & other BH needs (ADHD, eating disorders, etc.)
• Within Medicare, these members have claims cost over 2x of members without BH needs
• Within Medicaid, these members have claims costs over 7x of members without BH needs

               

The BH Leader will lead a transformative effort to define our future-state operating model for Behavioral Health to improve health outcomes, reduce medical costs, enhance operational efficiency, reduce provider/member abrasion, and improve compliance across Medicare and Medicaid.

Ultimately, this person is responsible for developing and deployment of a new, end-to-end Behavioral Health model at Humana, balancing access, affordability, and health outcomes.

This role plays a pivotal part in enhancing the overall quality of healthcare services, improving our efficiency and effectiveness in delivering behavioral health care, fostering strong relationships with our internal and external stakeholders, and meeting state and federal expectations. 

The BH Leader will work with a dedicated executive governance committee with balanced representation across Medicare and Medicaid. The team will consist of 3-5 BH experts reporting into the BH leader. They will also have an aligned DRI from each member of the governance team – this person will be accountable for the initiative’s success from the POV of their functional / operational area.

Key Responsibilities

• Develop and execute an enterprise-wide behavioral health strategy that sustainably improves behavioral outcomes for our members across insurance segments (Medicare and Medicaid)
• 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 Human