Clevelcrossing

With models ranging from home health to in home wellness assessments to in-home primary and acute care, the Home is a core part of Humana's overall integrated care delivery strategy, and we believe the Home is the next frontier in high touch, value-based care for our members.. In particular, the AVP will play a critical leadership role in the development of processes relating to Medicare risk adjustment, documentation, and in-home wellness assessments (in partnership with Humana's Medicare Risk Adjustment team, as well as with external strategic partners), given the importance of these areas to the delivery of value-based care.. 10 years of experience in a combination of healthcare strategy and healthcare operations. Significant experience with Medicare products and processes, with particular focus on Medicare risk adjustment, documentation, and/or in home wellness assessments. DescriptionThe Technology Chief Financial Officer, ('Tech CFO ') is responsible for financial leadership of Humana's global Tech operations, including strategy and execution from new project prioritization and planning to ongoi

advancement

Description

Humana is a Fortune 60 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana starts from within, and is committed to providing progressive benefits that advance team members' careers and job satisfaction. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.

Within Humana, the Home Solutions segment is a rapidly growing vertical focused on advancing home-centric care models built around improved member experience and outcomes. With models ranging from home health to in home wellness assessments to in-home primary and acute care, the Home is a core part of Humana's overall integrated care delivery strategy, and we believe the Home is the next frontier in high touch, value-based care for our members.

Responsibilities

Against that backdrop, we are seeking an innovative and forward-thinking leader for the position of Associate Vice President, Strategy Advancement within the Home segment. The overarching purpose of this role is standing up and advancing key emerging care models built around home as site of care, with particular focus on in-home primary care. The scope of this role will extend from shaping and influencing strategy related to these care models, to developing and implementing operational approaches to standing them up within Humana, to growing their footprint and membership over time, to leading strategy management and reporting for these care models. This role will work directly with executive and C-suite level leaders both within Humana and at key strategic partners. In-home primary care will be the top initial focus of this role, with the intention to expand to additional models over time.

Initially, the AVP will have one direct report, with desire to build out a high performing team of 2-3 direct reports in the next 12 months.

Key Responsibilities:

Shaping and influencing strategy for home-centric care models, with initial focus on in-home primary care. This includes identifying opportunities to improve care model design, strengthen member experience, increase operational efficiency, and improve financial return where appropriate. This leader will be in some cases directly defining and owning strategy, but in many cases will be playing a key partnership and influencing role with senior executives both within and outside Humana.
Designing and implementing operational approaches to stand up these home-centric care models within Humana. Innovative home-centric care models often require corresponding innovations in operational processes in order to enable implementation and scaling. Key examples include member engagement and enrollment, provider directory design, contract design and loading, claims processing, and compliance processes. This leader will have the operational experience and creativity to navigate these operational underpinnings that are so important to successful model realization. In particular, the AVP will play a critical leadership role in the development of processes relating to Medicare risk adjustment, documentation, and in-home wellness assessments (in partnership with Humana's Medicare Risk Adjustment team, as well as with external strategic partners), given the importance of these areas to the delivery of value-based care.
Scaling innovative home-centric care models through footprint expansion and membership growth. This leader will play a critical role in expanding access to emerging care models to a larger and larger percentage of Humana members over time. This will include partnering with Medicare leaders on market expansion, as well as with Marketing, Medicare leadership, and other Humana teams on intra-market growth.
Stakeholder relationship management and leadership. In addition to leading a team, a key crosscutting responsibility for the AVP will be owning executive and C-suite level relationships both across a diverse array of matrixed Humana teams (Retail Markets, MRA team, Contracting, DH&A, Home, etc.) and with key external partners, including Heal, Humana's strategic partner for home-centric primary care. This leader will work collaboratively to set and meet mutual cross-functional goals.
Strategy management and reporting. This leader will develop robust dashboards and milestones related to emerging home-centric care model performance and will provide data-driven updates and recommendations to senior leadership, including the Humana Management Team.

Required Qualifications

Bachelor's Degree
10 years of experience in a combination of healthcare strategy and healthcare operations
5 years of leadership specifically in the Medicare payer space, ideally with experience navigating payer-provider organizations
Broad array of competencies and experience ranging from high level strategy development to complex operational oversight and implementation
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Experience with high level strategic and operational focus within an MA payer or payer-provider organization
Thought leader who recognizes and opportunities to rethink status quo and is comfortable appropriately voicing these perspectives to drive change
Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs and win their co-ownership in the outcome
The polish, poise, and executive presence that will ensure effective interaction with senior and executive level audiences
Ability to work independently in an entrepreneurial, fast paced environment
Self-starter, comfortable with ambiguity and also execution oriented

Preferred Qualifications

MBA or other advanced degree
Proven ability to lead high profile horizontal initiative(s) within a matrixed MA payer or payer-provider organization
Significant experience with Medicare products and processes, with particular focus on Medicare risk adjustment, documentation, and/or in home wellness assessments
Significant experience with value-based primary care and/or home-centric care models

Additional Information

Position can be Work from Home. Preference is Louisville KY based

Scheduled Weekly Hours

40
DescriptionThe Technology Chief Financial Officer, ('Tech CFO ') is responsible for financial leadership of Humana's global Tech operations, including strategy and execution from new project prioritization and planning to ongoi...
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Job Code2117683Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of ...

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