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

Humana Healthy Horizons is seeking exceptional candidates to join our Medicaid Product Strategy Organization to advance Humana’s Medicaid products and capabilities to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

The Medicaid Capture Management team’s purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets. We deliver value through detailed research, data-driven insights, strategic planning, structured problem solving, and project management rigor.

We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes:

• Creative – Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
• Adaptive - Rapidly learn new knowledge, skills, and behaviors in response to changing circumstances.
• Self-sufficient - Ability to navigate complex situations and independently produce high quality deliverables.
• Consultative – Build/sustain relationships and inform the work of others through actionable, objective insights.
• Strategic – Forward thinking capable of providing frameworks to maximize ability of limited resources to achieve growth.

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The Senior Strategy Advancement Professional will support initiatives to develop and execute strategy successfully positioning Humana to capture growth opportunities. This role will work horizontally across the organization, coordinating with Medicaid leadership and subject matter experts to synthesize, assess, and translate state requirements into actionable go-to-market strategy. The Senior Strategy Advancement Professional will consult with growth partners to design and optimize operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations served in target growth markets.

Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key Medicaid programs and subpopulations. Areas of focus include Care Management, Quality Improvement, Utilization Management, Population Health, Social Determinants of Health, Pharmacy, Behavioral Health, Long-Term Services and Supports, Health Information Technology, Enrollment, Member Services, Grievance and Appeals, Claims, Encounters, Program Integrity and Subcontractor Management.

Key Responsibilities include:

• Research and assess prospective new markets. Gather key information on market and regulatory landscape and translate state policy to discern impacts to Humana’s operating model.
• Coordinate operational teams to translate contract requirements, market intelligence, and industry best practices into a viable target operating model.
• Collaborate cross-functionally to design high-impact, innovative, and competitive programs, models, partnerships, and initiatives for upcoming growth opportunities.
• Develop project plans and roadmaps, driving timely completion of deliverables by cross-functional project team.
• Track project status and report on progress to leadership.
• Participate in the proposal development process. Provide content and recommendations to help shape responses to state procurements and clearly articulate Humana product strategy.
• Document and clearly communicate operating model features to relevant teams to support proposal development and transition to implementation.

Use your skills to make an impact
 

Required Qualifications

• Must work hours within the Eastern Standard Time Zone.
• Bachelor’s Degree with a strong record of academic achievement.
• 2+ years of experience in a Medicaid Managed Care Organization OR 2+ years of experience in strategy consulting supporting Medicaid managed care organizations.
• Experience in business development or strategy consulting.
• Excellent written and verbal communication (i.e. effective listening and speaking skills, ability to convey complex concepts with clarity).
• Strong problem-solving ability (i.e. adept at research and g