Humana Medicaid Business Development Operations Strategist - Louisville, KY OR Work at Home (WAH) in Chattanooga, Tennessee
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.
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 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 Business Development Operations Strategy Advisor will lead efforts to advance Humana’s Medicaid health plan operations in pursuit of growth opportunities. This role will consult with leadership and subject matter experts across the enterprise and the industry to evolve our provider delivery model.
This role will require experience of developing and implementing Medicaid operations strategies. Candidates will possess expertise across key areas of focus including enrollment, member services, grievances and appeals, claims, encounters, management information systems, program integrity, subcontractor oversight.
Key responsibilities include:
Gather key information on market and regulatory landscape in prospective new markets to inform product build.
Translate state administrative code language and procurement requirements to understand state’s ultimate vision.
Engage in stakeholder and provider/association level relationship development meetings in current and prospective new markets.
Coordinate business partners and collaborate with Medicaid leadership to advance health plan operational strategy
Define Humana’s operational 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 communications regarding Humana’s business goals, market strategy, policy, positioning, and outcomes in the Medicaid and Dual Eligible marketplace.
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 or health plan operations
Experience leading strategic projects & cross functional teams
Ability to operate in a faced paced environment under tight deadlines
Comprehensive knowledge of Microsoft Office Products (Word, Excel, PowerPoint, Visio)
Flexible scheduling (i.e. – occasional nights and weekends)
MBA programs with a specialization in Healthcare Management
Master’s Degree in Public Health programs
Project Management and Process Improvement qualifications
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Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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