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

Join Humana as a Utilization Management (UM) Strategy Principal, and play a pivotal role within Humana’s Utilization Management Strategy team, a collaborative group dedicated to leveraging data and insights to improve clinical outcomes, member experiences, and operational efficiency across our organization. The UM Strategy Principal analyzes complex challenges in utilization management, working directly with operations partners and executive leaders to develop and implement actionable, data-driven strategies that streamline care delivery and reduce unnecessary costs for both members and provider partners.

This position leads cross-functional teams in identifying high-impact opportunities, setting clear business priorities, and translating strategic recommendations into detailed execution roadmaps. The ideal candidate will demonstrate strong analytical and strategic thinking skills, thrive in ambiguous environments, and be passionate about driving measurable value through enterprise-wide collaboration.

This role offers the opportunity to directly influence the quality and effectiveness of our utilization management programs, while contributing to the team's broader mission of transforming healthcare delivery at Humana.

The UM Strategy Principal will analyze complex problems and issues related to utilization management using data and insights from internal and external sources. They will bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans.

This role is highly collaborative and will work closely with associates and executive leaders from across the enterprise to solicit input, guide data-backed problem solving, and make recommendations to advance utilization management strategy. Ultimately, they will work with operational owners to translate strategic recommendations to execution plans for implementation.

The UM Strategy Principal will:

• Engage in problem solving and medium to long term strategy setting.
• Use data and insight from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members/providers/associates in utilization management programs.
• Lead cross-functional teams to define discrete opportunities that are both impactful and achievable.
• Work directly with cross-functional partners across the enterprise to create the execution model and roadmap to capture prioritized opportunities.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree with 6+ years of experience driving and creating strategy OR Master’s level degree with 4+ years of the same experience.  
• 2 years of experience in strategy or management consulting.
• Experience leveraging/interpreting data and analytics to improve strategy and make recommendations.
• Proven skills influencing others and a track record of success leading through ambiguity.
• Proven organization, planning and prioritization skills to collaborate with multiple enterprise departments and stakeholders with the ability to execute within deadlines.
• Experience working independently to manage projects to achieve objectives.
• Intermediate to advanced level of competency with Microsoft Office suite (PowerPoint, Excel).

Preferred Qualifications

• Exposure or experience with clinical operations and/or utilization management.
• Health care industry experience.

Additional Information

• Workstyle: Remote, work from home.
• Travel: potential for quarterly travel for on-site meetings.
• Typical work days/hours: Monday – Friday, 8:00 am – 5:00 pm EST.

WAH Internet

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 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.

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