Director, Enterprise Activation – Provider Performance Strategy

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $150k - $206.3k / year

⏰ Full Time

🔴 Lead

👔 Director

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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, provider technology solutions, connectivity initiatives, data quality, and performance governance • Develop and optimize tools, programs, insights, and operational capabilities supporting providers, markets, and enterprise partners in improving Medicare Stars performance and health outcomes • Serve as enterprise owner for provider-facing reporting, performance frameworks, provider optimization programs, and technology-enabled solutions • Partner with PCP Enablement and Market Consultation teams to deploy and utilize enterprise capabilities effectively • Lead Stars strategy, governance, and optimization of enterprise provider reporting, dashboards, provider-facing feature functionality, action-planning capabilities, reporting rules, and performance management tools • Define business requirements and improve usability across Compass, Availity, POCA, provider data feeds, supplemental data submission, interoperability, and emerging workflow solutions • Partner with Digital and IT to advance provider access to actionable performance information • Lead governance, performance management, capability assessment, ROI/value realization, and optimization of provider-focused Stars programs and strategic vendor relationships • Develop enterprise-wide Stars provider engagement, segmentation, activation, and optimization strategies • Align reporting, incentives, programs, technology, Markets, Stars, and Provider organizations to improve quality performance and drive coordinated execution • Collaborate with Markets, Provider Enablement, Clinical, Digital, Analytics, Operations, IT, and external provider organizations • Travel up to 20%

🎯 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 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 technology organizations • Experience supporting provider groups, value-based care arrangements, and National Strategic Providers • Experience with provider-facing technology platforms and digital provider solutions • Experience managing strategic vendor relationships and provider-facing solutions • Experience with healthcare interoperability, APIs, FHIR, HL7, and healthcare data exchange models • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Ability to work from a dedicated space lacking 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 • Home 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