Humana Medicaid Clinical Strategist - Louisville, KY OR Work at Home (WAH) in Sandy, Utah

Description

Humana Medicaid is seeking exceptional candidates to join our Strategy & Business Development team in order to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

Responsibilities

The Medicaid Business Development’s purpose is to lead the organization in advancement of Humana’s Medicaid and LTSS products. This work includes collaboration with a diverse group of internal and external stakeholders to pursue growth opportunities and guide transformative initiatives. We deliver value to executive leadership through detailed research, data-driven insights, structured problem solving, and project management rigor. To achieve our goals we are committed to creating a diverse, collaborative work environment that empowers associates to rethink routine and pioneer simplicity.

The Medicaid Clinical Strategist will lead initiatives to advance Humana’s Medicaid Care Delivery Model in pursuit of growth opportunities. This role will consult with clinical leadership and subject matter experts across the enterprise and the industry to build and evolve our model, as well as to form partnerships with external organizations.

Candidates will possess Medicaid integrated care delivery expertise and have experience in designing solutions for key Medicaid programs and subpopulations. Areas of focus include Care Coordination, Chronic Care Management, Quality Improvement, Utilization Management, Social Determinants of Health, Pharmacy, Behavioral Health and LTSS.

Key responsibilities include:

  • Gather key information on market and regulatory landscape in prospective new markets to inform product build.

  • Engage in stakeholder and provider/association level relationship development meetings in current and prospective new markets.

  • Translate state administrative code language and procurement requirements to understand state’s ultimate vision.

  • Develop clinical strategies to exceed regulatory requirements and successfully position Humana’s Medicaid/LTSS/Dual products in the marketplace.

  • Define Humana’s clinical delivery model and translate into winning proposals.

  • Oversee project plans, project schedules, resource assignment matrixes, etc. at the outset of each bid.

  • Drive timely completion of internal/external deliverables by cross functional project team.

  • Track project status and report on progress to leadership.

  • Help develop materials for internal and external presentations and communications regarding Humana’s business goals, market strategy, policy, positioning, and outcomes in the Medicaid and Dual Eligible marketplace.

Required Qualifications

  • Bachelor’s Degree with a strong record of academic achievement

  • 2+ years’ experience in a Medicaid or Medicare Managed Care Organization

  • 2+ years’ experience in business development, strategy consulting, clinical strategy

  • Strong problem solving skills

  • Excellent verbal and written communication skills

  • Ability to operate in a faced paced environment under tight deadlines

  • Advanced Proficiency in Microsoft Office Products (Word, Excel, PowerPoint, Visio)

  • Flexible scheduling (i.e. – occasional nights and weekends)

Preferred Qualifications

  • MBA programs with a specialization in Healthcare Management

  • Master’s Degree in Public Health programs

  • Project Management and Process Improvement qualifications

Additional Information

  • Role will include travel (10-20% of time)

Scheduled Weekly Hours

40

About Us

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

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