Humana

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.

VP, Foundational Capabilities

Vice PresidentVice PresidentFull TimeRemoteTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

Kentucky

Posted

65 days ago

Salary

Not specified

Bachelor Degree5 yrs expEnglishPMP

Job Description

• Lead strategic initiatives to transform and advance Stars back to industry leading • Monitor and analyze industry trends, CMS updates, competitor activity, and market dynamics that impact the Medicare Stars landscape • Develop and communicate insights to inform organizational strategy and ensure proactive responses to changes in the regulatory and competitive environment • Ensure top executives are well informed and have the right information on competitive intelligence to make decisions • Oversee strategy and integration of digital tools, automation, and artificial intelligence to enhance operational efficiency • Evaluate, select, and implement innovative technology solutions that streamline Stars data capture, analytics and operational impact • Partner with IT, Digital and Experience teams to ensure emerging opportunities are integrated • Develop engagement models to enhance provider connectivity • Design educational programs and resources that equip providers and members with actionable data • Establish feedback mechanisms to gather input and continuously improve partnership effectiveness • Serve as the primary liaison between internal teams, external partners, vendors, and regulatory agencies for Stars initiatives • Lead cross-functional workgroups to align priorities, share knowledge, and ensure accountability in delivering on Stars objectives • Manage long term strategic planning with strategic partners

Job Requirements

  • Bachelor’s Degree in Business Administration, Health Administration or a related field
  • Progressive experience in the health solutions industry, with emphasis on leading and managing teams
  • Prior Medicare/Medicaid experience
  • Knowledge of HEDIS/Stars and CMS quality measures
  • Prior managed care experience
  • Proficiency in analyzing and interpreting healthcare data and trends
  • Strong attention to detail and focus on process and quality
  • Excellent communication skills
  • Ability to operate under tight deadlines
  • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
  • Master’s degree in business administration, Health Administration or a related field (preferred)
  • 5 or more years of Stars experience (preferred)
  • Proven organizational and prioritization skills and ability to collaborate with multiple departments (preferred)
  • PMP certification a plus (preferred)
  • Six Sigma Certification also a plus (preferred)
  • Experience with AI and emerging Digital/Technology solutions (preferred)

Benefits

  • Competitive Intelligence
  • Stars Technology Advancement
  • Provider and Member Engagement
  • Partner Coordination

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