Program Delivery Lead

🕒 4 dias atrás

🏄 California, Illinois, +2 estados a mais – Remoto

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💵 $115.200 - $158.400 / ano

⏰ Tempo Integral

🟠 Sênior

🦅 Patrocina Visto H1B

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👻 Score fantasma 0%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Humana

10.000+ funcionários

Fundada em 1961

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.

Descrição

• Drive the product lifecycle for assigned products within the behavioral health portfolio • Translate portfolio strategy into actual product delivery • Form cross-departmental colleague teams to support product delivery • Set prioritization and maintain alignment of effort • Own delivery of assigned products • Advance Humana’s behavioral health network quality and access across Medicare Advantage and Medicaid lines of business • Establish and maintain real-time insights into behavioral health network access, including SUD, ASD, and dementia specialty areas • Develop, implement, and manage provider scorecards and tiering systems • Partner with MA and MCD network teams, the MA network adequacy team, and market leadership teams • Launch and lead Pay-for-Performance projects for MA providers • Support and expand P4P programs within MCD • Manage Joint Operating Committees and relationships with large provider groups • Serve as contact for issue resolution, troubleshooting, and strategic partnership development

🎯 Requisitos

• Bachelor’s Degree • 8+ years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting • Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives • Proven ability to work with multiple stakeholders, lead cross-functional teams, and implement strategic initiatives • Strong analytical skills, with experience in provider performance measurement and network adequacy • Demonstrated ability to articulate ideas effectively in both written and oral forms • Experience with value-based care and pay-for-performance models • In-depth knowledge of behavioral health provider networks for both MA and MCD populations • Ability to manage complex provider relationships and drive collaborative outcomes • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for home internet • Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefícios

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Internet expense payment for employees who live and work from home in California, Illinois, Montana, or South Dakota • Telephone equipment appropriate to business requirements • Remote work arrangement • Occasional travel to Humana offices for training or meetings

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