Director, Enterprise Activation Provider Performance Strategy

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $150k - $206.3k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Lead Enterprise Activation's provider performance infrastructure, including provider strategy, provider programs, reporting and dashboard capabilities, connectivity initiatives, data quality, and performance governance • Develop and optimize programs, insights, and roadmaps supporting providers, markets, and enterprise partners in improving Medicare Stars performance and health outcomes • Own enterprise provider-facing capabilities, including reporting, performance frameworks, provider optimization programs • Lead Stars strategy, governance, and optimization of enterprise provider reporting, dashboards, provider-facing quality improvement programming, and performance management • Lead governance, performance management, and optimization of provider-focused Stars programs and provider-facing engagement and quality improvement solutions • Develop enterprise-wide Stars provider engagement, segmentation, activation, and optimization strategies • Align reporting, incentives, programs, Markets, and Provider organizations to improve quality performance, remove adoption barriers, and drive coordinated execution • Partner with Markets, Provider Enablement, Clinical, Digital, Analytics, Operations, IT, and external provider organizations to deploy scalable, outcome-focused strategies • Lead provider reporting data connectivity, performance governance, and effectiveness to drive Stars performance

🎯 Requirements

• Bachelor's degree • 8+ years of progressively responsible leadership experience in Medicare Advantage, provider performance, quality improvement, population health, healthcare analytics, provider engagement, or 5 years of experience at a top tier consulting firm • 3+ years of working experience in Medicare Advantage Stars, HEDIS, quality measurement, and provider performance improvement • Experience developing provider reporting, performance management, or provider engagement and experience strategies • Experience analyzing provider quality and performance data across Medicare Advantage, Stars, HEDIS, value-based care, or related healthcare programs • Experience leading enterprise-wide initiatives across multiple business functions • Strong strategic planning, business analysis, and program management skills • Experience managing complex stakeholder relationships across business and clinical organizations • Experience supporting provider groups and value-based care arrangements • Experience with healthcare interoperability, APIs, FHIR, HL7, and healthcare data exchange models • Black belt, Six Sigma, SQL/Python coding • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for self-provided internet service • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Telephone equipment appropriate to business requirements • Bi-weekly internet expense payment for employees who live and work from home in California, Illinois, Montana, or South Dakota