Description

Humana is a publicly traded, Fortune 100 healthcare company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60’s, to the largest US hospital corporation in the 80’s, to a leading health company beginning in the 90’s. Today, Humana is a leader in consumer-focused health solutions and is one of the largest healthcare organizations in the country.

Responsibilities

Humana’s Retail business segment is comprised of the company’s Medicare and Medicaid businesses. Retail is Humana’s largest business segment, comprising over 80% of the company’s total revenue and the majority of its earnings. Humana has a rapidly growing presence at the intersection of Medicare Advantage and Medicaid through serving Dual Eligible consumers in our MAPD and DNSP plans. Humana is seeking an experienced executive to focus on accelerating growth, transforming the customer experience, and improving health outcomes of our Duals membership. The Associate Vice President, Duals Segment, creates impact at the intersection between Humana’s core insurance operations, care businesses and local markets by developing and delivering against an ongoing 3 year strategic roadmap, while ensuring annual progress and continuous improvement across objectives and key results. This role will rely heavily on an in-depth understanding of how managed care organizations can create value for the Dual Eligible population and key stakeholders in the healthcare ecosystem.

Key Responsibilities

• Set, manage and deliver an ongoing 3 year Duals strategy and growth roadmap inclusive of organic and inorganic opportunities in partnership with key corporate functions and regional insurance businesses
• Coordinate stakeholders within core Humana functions to deliver an integrated human care experience across multiple aspects of the consumer journey for Duals members (e.g., sales and distribution, insurance product design, customer service, digital product and experience development, provider network, health care services, etc.)
• Build relationships with regional insurance organizations to drive membership growth, deploy products, customize and iterate offerings based on local conditions and insights, and ensure consistency in consumer experiences and capabilities where essential to quality and national scalability
• Drive business case development to support change management initiatives required to deliver on desired growth, customer experience and health outcomes
• Establish and manage quarterly Objectives and Key Results in partnership with others in the organization to drive growth, experience and health outcomes for the Duals population

Required Qualifications

• Master's Degree
• 10 or more years of experience within US managed care or similar organization
• 8 or more years of leadership experience
• Experience with integrated payment and care models between Medicare and Medicaid programs
• P&L accountability or strategic leadership experience within a large Medicare or Medicaid organization and/or integrated health system
• Demonstrated success driving organic and/or inorganic growth in highly regulated and dynamic environment
• Ability to lead and influence through horizontal and matrixed team models in a large organization
• Experience managing end-to-end decision making, including decision or input-rights into sales, marketing, product, customer service, clinical, quality, plan operations and technology decisions
• Experience driving organizational transformation, including operating and clinical model changes to drive health outcomes and membership growth

• Strong background in social determinants of health and impact on health outcomes
• Experience with Medicare and/or Medicaid product design and new innovative plan benefit design programs

• Strong communications and facilitation skills with proven track record of engaging with C-level executives and Board-level stakeholders
• Passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Experience with provider network development, and innovative risk arrangements and incentive structures
• Experience building and managing strong collaborative relationships with state Medicaid agencies
• Experience with human-centered design and primary consumer research to inform perspectives on critical needs and business opportunities
• Experience with agile development and testing methodologies