Advisor, Medicaid Network Strategy

24 Apr 2024

Vacancy expired!

DescriptionThe Advisor, Medicaid Network Strategy will be accountable for leading the development of Humana Healthy Horizon's (Medicaid) network strategy for its growth markets. This network strategist will provide data-driven strategic direction to the development of adequate and accessible networks and translation of strategy into playbooks. The Advisor also supports of multi-functional efforts to identify, interpret, and produce network build plans based on company and external data analysis. The position requires an in-depth understanding of how organizational capabilities interrelate within the enterprise in order to develop and execute on network strategy. This position exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.ResponsibilitiesKey ResponsibilitiesAccountable for network development strategies in growth markets informed by data and advanced market intelligence

Oversee creation of network development playbooks, including market and contractual analyses, contracting strategies and targets, value-based payment strategies, and operational considerations, that drive adequate and accessible provider network builds

Conduct market and competitor research to inform optimized networks and provider partnerships

Analyze and synthesize data from internal and external sources to inform network strategy and solve complex business problems

Establish network build and implementation timelines for each growth market in partnership with Medicaid Network Implementation and Business Development teams

Partner with business development and contracting teams to execute on playbook strategies for developing new networks that meet network access and unit cost objectives

Inform Medicaid request for proposal (RFP) responses related to providers in alignment with segment goals and network development playbooks

Required QualificationsBachelor's degree

5+ years of experience in network development, contracting, and/or operations

2+ years of project leadership experience

2+ years of Medicaid experience

Experienced strategist with track record of synthesizing and evaluating multiple sources of qualitative and quantitative data to define network priorities and build solutions

Proven ability to interpret and utilize competitive intelligence, state regulatory and contractual requirements, and financial analyses to inform strategy

Preferred QualificationsMaster's degree

Experience in LTSS network development or contracting

Additional InformationLocation, Remote NationwideVaccine Policy:For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.If progressed to offer, you will be required to: Provide proof of full vaccination, including booster or commit to testing protocols OR   Provide proof of applicable exemption including any required supporting documentation. Medical, religious, state and remote-only work exemptions are available.Work-At-Home Requirements:WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Why Humana?At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:Work-Life Balance

Generous PTO package

Health benefits effective day 1

Annual Incentive Plan

401K - Immediate company match

Well-being program

Paid Volunteer Time Off

Student Loan Refinancing

If you share our passion for helping people, we likely have the right place for you at Humana.Social Security Task:Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.Interview Format:As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.Scheduled Weekly Hours40

Full-time
  • ID: #39373027
  • State: Vermont Montpelier 05601 Montpelier USA
  • City: Montpelier
  • Salary: USD TBD TBD
  • Showed: 2022-04-24
  • Deadline: 2022-06-23
  • Category: Et cetera