Program Delivery Lead

🔥 13 hours ago

🏄 California, Illinois, +2 more states – Remote

🏄 California – Remote 🌽 Illinois – Remote 🦬 Montana – Remote 🗿 South Dakota – Remote

💵 $115.2k - $158.4k / year

⏰ Full Time

🟠 Senior

🦅 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

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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